A Technique for Slit Scanography

Woodruff, John H.; Lane, Gerald R.

doi:10.2214/ajr.96.4.907

Cited by 2 publications

(3 citation statements)

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“…9). The accuracy of a slit scanogram in measuring limb length has been widely investigated 13,14,[23][24][25] . The biplanar slot-scanning radiograph technique has been widely used in orthopaedic practices to assess limb length [26][27][28][29] .…”

Section: Discussionmentioning

confidence: 99%

Normative Femoral and Tibial Lengths in a Modern Population of Twenty-First-Century U.S. Children

Chen

Milbrandt

Babadi

et al. 2023

Journal of Bone and Joint Surgery

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Background:The Green-Anderson (GA) leg-length data remain the gold standard for the age-based assessment of leg lengths in children despite their methodologic weaknesses. We aimed to summarize current growth trends among a cross-sectional cohort of modern U.S. children using quantile regression methods and to compare the median femoral and tibial lengths of the modern U.S. children with those of the GA cohort.Methods:A retrospective review of scanograms and upright slot-scanning radiographs obtained in otherwise healthy children between 2008 and 2020 was completed. A search of a radiology registry revealed 3,508 unique patients between the ages of 2 and 18 years for whom a standard-of-care scanogram or slot-scanning radiograph had been made. All patients with systemic illness, genetic conditions, or generalized diseases that may affect height were excluded. Measurements from a single leg at a single time point per subject were included, and the latest available time point was used for children who had multiple scanograms made. Quantile regression analysis was used to fit the lengths of the tibia and femur and overall leg length separately for male patients and female patients.Results:Seven hundred patients (328 female and 372 male) met the inclusion criteria. On average, the reported 50th percentile tibial lengths from the GA study at each time point were shorter than the lengths in this study by 2.2 cm (range, 1.4 to 3.3 cm) for boys and 2 cm (range, 1.1 to 3.1 cm) for girls. The reported 50th percentile femoral lengths from the GA study at each time point were shorter than the lengths in this study by 1.8 cm (range, 1.1 to 2.5 cm) for boys and 1.7 cm (range, 0.8 to 2.3 cm) shorter for girls.Conclusions:This study developed new growth charts for femoral and tibial lengths in a modern U.S. population of children. The new femoral and tibial lengths at nearly all time points are 1 to 3 cm longer than traditional GA data. The use of GA data for epiphysiodesis could result in underestimation of expected childhood growth.Level of Evidence:Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Normative Femoral and Tibial Lengths in a Modern Population of Twenty-First-Century U.S. Children

Chen

Milbrandt

Babadi

et al. 2023

Journal of Bone and Joint Surgery

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“…Also, pediatric orthopaedists need to consider radiation dosage, magnification, reliability, and availability of full-length weight-bearing radiographs before deciding which imaging modality to utilize in children. Early reports focused on comparing teleoroentgenogram, orthoroentgenogram, scanogram, microdose digital radiography, and CT scanogram to give the most precise length measurements 3,4,14–16. With the implementation of EOS in the last decade, more precise measurements can be obtained than from conventional radiographs and CT scanogram 7.…”

Section: Discussionmentioning

confidence: 99%

“…Early reports focused on comparing teleoroentgenogram, orthoroentgenogram, scanogram, microdose digital radiography, and CT scanogram to give the most precise length measurements. 3,4,[14][15][16] With the implementation of EOS in the last decade, more precise measurements can be obtained than from conventional radiographs and CT scanogram. 7 Our study compared phantom length measurements by EOS, teleoroentgenograms, and orthoroentgenograms.…”

Section: Measurement Variationsmentioning

confidence: 99%

Applications and Error Ratios of Calibration Techniques in EOS, Orthoroentgenogram, and Teleoroentgenogram for Length Measurement: A Comparative Study

Asma

Nichols²,

Ulusaloğlu³

et al. 2021

Journal of Pediatric Orthopaedics

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Background: Accurate length measurements of extremity bones are essential in treating limb deformities and length discrepancies in children.Objective: This study aimed to determine errors in common techniques used to measure lower limb lengths in children. Methods: Precision and instrument errors in length measurements were studied utilizing electro-optical system (EOS), orthoroentgenogram, and teleoroentgenogram The goal was to measure a 70-cm metallic rod phantom (average length of the lower extremity of a 10-year-old boy in the 50th percentile) in 3 phases. In Phase 1, the length measurements were performed in an EOS unit with internal calibrations, a magball/magstrip in various scan positions, and measurement with TraumaCAD software. In Phase 2, the measurements were repeated utilizing a single radiation "shot" teleoroentgenogram. In Phase 3, an orthoroentgenogram was utilized with a radiopaque ruler reference. The reliability and validity of measurements were calibrated by 4 physicians (a radiologist, senior orthopaedic attending, and 2 orthopaedic fellows). Results: EOS measurements utilizing internal references had excellent accuracy (for a 700-mm real length, magnification error (ME)] of 0.09%. Teleoroentgenogram with a magball reference and measurements performed with automatic calibration by TraumaCAD program results in ME of 1.83% with insignificant intraobserver/interobserver difference. Teleoroentgenogram with a magball or magstrip reference measured manually showed that the magball has higher intraobserver/interobserver variance than magstrip, with a 6.60 and 0.33-mm SD, respectively. The length by manual measurement utilizing the magstrip has ME of 2.21%. Orthoroentgenogram is accurate with ME of 0.26%, but does not allow anatomical analysis and is also radiation-costly. Conclusion:EOS and orthoroentgenogram are very accurate for length measurements. Teleoroentgenogram is less accurate in measuring length; however, addition of an external reference (magball, magstrip) placed lateral to the target improves accuracy. Automatic calibration with computer-based analysis of the external reference improves the accuracy more than manual calibration. If manual calibration is utilized, the length measurement is less accurate with the magball than the magstrip. Level of Evidence: Level II-comparative in vitro study.

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A Technique for Slit Scanography

Cited by 2 publications

References 0 publications

Normative Femoral and Tibial Lengths in a Modern Population of Twenty-First-Century U.S. Children

Normative Femoral and Tibial Lengths in a Modern Population of Twenty-First-Century U.S. Children

Applications and Error Ratios of Calibration Techniques in EOS, Orthoroentgenogram, and Teleoroentgenogram for Length Measurement: A Comparative Study

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