https://www.oarsi.org/sites/default/files/library/2013/pdf/part_iii_changes_in_evidence2010.pdf

OARSI recommendations for the management of hip and knee osteoarthritis: part III: Changes in evidence following systematic cumulative update of research published through January 2009

https://www.oarsijournal.com/article/S1063-4584(07)00234-8/pdf

OARSI recommendations for the management of hip and knee osteoarthritis, part I: critical appraisal of existing treatment guidelines and systematic review of current research evidence.

Purpose: To determine, in a meta-analysis, the diagnostic performance of contrast material–enhanced magnetic resonance (MR) imaging in patients with breast lesions. Materials and Methods: Studies to assess the diagnostic performance of MR imaging in patients suspected of having breast cancer who underwent MR imaging and biopsy from January 1985 through March 2005 were reviewed for inclusion. A summary receiver operating characteristic curve was constructed, and pooled weighted estimates of sensitivity and specificity were calculated by using the recently developed bivariate approach for diagnostic meta-analysis. Results: Of 251 eligible studies, 44 were included in the meta-analysis (sample size range, 14–821; cancer prevalence, 23%–84%). Pooled weighted estimates of sensitivity and specificity were 0.90 (95% confidence interval: 0.88, 0.92) and 0.72 (95% confidence interval: 0.67, 0.77), respectively. The performance of breast MR imaging was influenced by the prevalence of cancer in the studied populatio...

Meta-Analysis of MR Imaging in the Diagnosis of Breast Lesions

The supraclavicular region is a common site for lymph node metastases. A commonly reported type of nonmalignant 18F-FDG uptake on PET imaging in the supraclavicular region is “muscle uptake” purportedly due to muscle contraction in tense patients during the 18F-FDG uptake phase. PET/CT offers the unique opportunity to correlate PET findings with CT anatomy in the supraclavicular region. Methods: Images from the first 359 consecutive clinical whole-body studies (in 347 patients) using 18F-FDG and a PET/CT scanner (with CT attenuation correction and ordered-subsets expectation maximization [OSEM] reconstruction) were retrospectively reviewed. The supraclavicular region was evaluated for the presence of abnormal uptake on PET images, and the corresponding CT findings were assessed. Three distinct patterns of abnormal 18F-FDG uptake were noted: pattern A (uptake localizing to supraclavicular area fat [USA-fat], i.e., without corresponding lymph node or muscle uptake on CT), pattern B (uptake localizing to muscle on CT), and pattern C (uptake localizing to lymph nodes or soft-tissue masses on CT). Results: Forty-nine patients (14.1%) (32 female, 17 male; mean age, 51.4 ± 15.6 y; age range, 12–77 y) showed abnormal 18F-FDG uptake in the supraclavicular region. Twenty patients (5.8%) had muscle uptake (group B); 15 (4.3%) had definite abnormal lymph nodes (group C). However, 14 patients (4.0%) had USA-fat (group A) and foci of very low Hounsfield units on CT. These foci were also present on 68Ge attenuation-corrected images (when obtained) and non-attenuation-corrected images. Uptake in USA-fat was typically bilateral and symmetric, intense, more often multifocal than linear, and located in fat on PET/CT. Age was not significantly different for group C versus the 2 other groups. Intensity; mean standardized uptake value, lean (SUVL MEAN); or maximum standardized uptake value, lean (SUVL MAX), did not allow differentiation between patterns A and C (P > 0.05). Standardized uptake values (SUVL MAX, 3.1; SUVL MEAN, 2.1) were significantly lower in group B than in the 2 other groups (P

https://jnm.snmjournals.org/content/jnumed/44/2/170.full.pdf

Uptake in Supraclavicular Area Fat (“USA-Fat”): Description on 18F-FDG PET/CT

Objective: The aim of the present study was to analyze the current status of morphologic and functional thyroid abnormalities in a previously iodine-deficient area. Methods: The population based St...

The prevalence of undiagnosed thyroid disorders in a previously iodine-deficient area

A variety of indications for radiosynoviorthesis have been reported in literature, but the clinical outcome differs and depends on the primary disease and the pre-existing degenerative changes. This metaanalysis was carried out to establish groups for radiosynoviorthesis based on clinical outcome with respect to primary disease, clinical stage and the pre-existing degenerative changes. The literature search was carried out using the MEDLINE search term 'radionuclide synovectomy'. Based on reports in the literature we determined groups for radiosynoviorthesis for clinical use. Our literature list comprised 2190 joints that were treated with radiosynoviorthesis. The overall response rate for all treated joints was 72.5+/-17%. The mean improvement rate for the treated joints in rheumatoid arthritis was 66.7+/-15.4%. For osteoarthritis the success rate was 56+/-11%, with better results in case of minimal radiological changes. Radiosynoviorthesis in patients with changes according to Steinbrocker I and II was successful in 72.8+/-12.3%, and in 64+/-17.3%, respectively. Steinbrocker III and IV had a mean success rate of 52.4+/-23.6%. In the case of haemophilia and Willebrand's disease a reduction of joint bleedings and factor usages after radiosynoviorthesis was evident in 91+/-4.3%. In patients with pigmented villonodular synovitis radiosynoviorthesis was successful in 77.3+/-25.3%. It is concluded that radiosynoviorthesis provides better results in rheumatoid arthritis than in osteoarthritis. Minimal or moderate changes according to Steinbrocker stages I and II respond better to radionuclide therapy than do stages III and IV. Deformed or unstable joints might fail treatment and therefore surgical interventions should be considered. Close cooperation with orthopaedists and rheumatologists is necessary to consider radiosynoviorthesis in each patient to ensure optimal medical care.

Clinical outcome of radiosynoviorthesis: a meta-analysis including 2190 treated joints.

Until 1963 Austria was an extremely iodine-deficient area with low iodine intake and high goiter prevalence. Therefore, for the first time in 1963, salt iodination with 10 mg of potassium iodide per kilogram of salt was introduced by federal law. Twenty years after this salt iodination, however, investigations in schoolchildren demonstrated iodine deficiency grade I to II according to the World Health Organization (WHO) (urinary iodine excretion, 42-75 microg/g Crea) and goiter prevalence of far more than 10%. In 1990, salt iodination was increased to 20 mg of potassium iodide per kilogram of salt. In 1994, further investigations in schoolchildren demonstrated an increase of urinary iodine excretion (121 microg/g Crea) and a reduction of goiter prevalence below 5%, with the exception of pupils ages 14-19 (12%). In the year 2000, 10 years after the increase of salt iodination in Austria, 430 nonselected adult inhabitants of three communities in Carinthia (a county of Austria) were investigated for iodine excretion, goiter prevalence, and prevalence of thyroid autoantibodies. This study demonstrated that although iodine supply is sufficient now in Austria (males, 163.7 microg of Crea; females, 183.3 microg of iodine per gram of Crea), goiter prevalence is still high in the elderly, who lived for a longer period of iodine deficiency (34.3% in women and 21.3% in men), whereas goiter prevalence in younger people up to age 40 years is below 5%. It could also be shown that the percentage of thyroid autoantibodies is now as high as in other countries with sufficient iodine supply (3.19% in males, 5.17% in females). In addition to the changes of urinary iodine excretion and goiter prevalence because of salt iodination, changes of incidence in hyperthyroidism and histologic types of thyroid cancer are discussed in this paper. In conclusion, the introduction of salt iodination led to an improvement in iodine supply with a marked reduction of goiter prevalence in people who were born after 1963, but also to an increase in hyperthyroidism and autoimmune thyroid diseases as well as changes in histologic types of thyroid cancer.

Iodine supplementation in Austria: methods and results.

The objective of this epidemiologic study was to determine the volume of the thyroid gland as well as urinary iodine excretion in dependence on age and gender in a population from an area of low natural iodine supply now receiving iodine prophylaxis. In 430 persons from three communities in the province of Carinthia, Austria, we determined thyroid volume via sonography as well as urinary iodide excretion. As in numerous other European countries, natural iodine supply is insufficient in Austria. Therefore, to reduce goiter incidence, iodization of common salt with 10mg potassium iodide (KI) per kilogram of NaCl was made mandatory in Austria in 1963 by federal law. In 1990, the amount of iodine addition was increased to 20mg KI per kilogram of NaCl. Our results show that mean urinary iodide excretion in the persons investigated was altogether satisfactory (males: 163.7 μg of iodine per gram of creatinine; females: 183.3 μg of iodine per gram of creatinine). Goiter prevalence was 34.3% in women and 21.3% in ...

Goiter Prevalence and Urinary Iodide Excretion in a Formerly Iodine-Deficient Region After Introduction of Statutory Iodization of Common Salt

A 43-year-old woman had a 3-day history of abdominal pain. Results of gastroscopy and abdominal sonography were negative. After 3 days, she also had fluid and hemorrhagic diarrhea. Laboratory examination showed low potassium, and the leukocyte count was very elevated. Chest radiographs obtained during routine work-up showed multiple hyperdense areas possibly indicative of a malignant disease. Therefore, F-18 fluorodeoxyglucose (FDG) positron emission tomography was performed. Striking F-18 FDG uptake was seen in the wall of the colon over its entire length, indicative of acute colitis, whereas the pulmonary foci were negative. The pulmonary foci later were determined to be inactive granulomatous disease. Analysis of the fluid stools revealed Salmonella infection. The patient was treated with antibiotic therapy and after a few days recovered.

F-18 fluorodeoxyglucose positron emission tomography in the diagnosis of inflammatory bowel disease.

Vocal cord muscle activity as a drawback to FDG-PET in the followup of differentiated thyroid cancer.

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