Osteogenesis Imperfecta is a hereditary connective tissue disorder due to COL1A1/2 mutation causing gene defect encoding proteins to metabolize collagen. The skeletal manifestation of OI causing bone incompetence, hence the name brittle bone disease. Here we report three cases of OI type IV in adults. Skeletal conventional X-rays were performed to all patients and all of them has similar results such as bowing deformities of long bones, old union and some non-union fractures with extreme angulation and severe osteoporosis. OI are classified based on skeletal structure, sclera colorization, dentinogenesis, and functional metabolic defect genetically. OI type I and IV can live until adults; also, the same type of OI can be found in siblings. Skeletal conventional X-rays can solely make the diagnosis.

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BACKGROUND: Anterior translation of the tibia (ATT) is a secondary sign of an anterior cruciate ligament (ACL) tear. With advances in technology, new tools such as the Lachmeter are expected to replace computed tomography scanning (CT scan) in measuring the ATT. AIM: This study aims to determine the diagnostic validity of the Lachmeter in measuring the ATT 6–12 months after ACL tear reconstruction. MATERIALS AND METHODS: A retrospective diagnostic test with a Lachmeter was used to measure ATT in patients 6–12 months after ACL tear reconstruction, compared with the gold standard CT scan and using a consecutive sampling technique. The optimal cutoff value of ATT was determined with Lachmeter afterwards. Statistical Package for the Social Sciences version 21.0 was used for the data analysis. RESULTS: There are 28 persons with a positive ATT (≥ 5 mm) and four people with a negative ATT (<5 mm) measured using CT scan out of 32 samples. The optimal cutoff of ATT with Lachmeter is ≥7.28 mm (Area under curve = 0.88, 95% CI, 0.67–1.00 and p = 0.004) with a sensitivity of 84.62%, specificity 83.33%, positive predictive value 95.65%, negative predictive value 55.56%, positive likelihood ratio (LR) 5.08, negative LR 0.18, and 84.38% accuracy. CONCLUSION: Lachmeter is a new tool for determining ATT that is highly efficient and easy to use. With good sensitivity and specificity values, this new tool has been proven to be very good at measuring ATT compared to CT scan as the gold standard.

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