TL;DR: No differences in accuracies between the methods were found for the detection of morphological TMJ changes, however, with panoramic examination and sagittal (lateral) scanography markedly more joint components were non-accessible to examination than with sagittal cross-sectional tomography, with which all components were accessible.
Abstract: Objectives: To compare the diagnostic accuracy of panoramic, scano- and tomographic examination for the detection of morphological temporomandibular joint (TMJ) changes. Methods: TMJs in 80 dry human skulls were radiographed using digital panoramic examination, 4× sagittal (lateral) scanography, and sagittal cross-sectional tomography. All images were examined by three independent observers for the presence or absence of flattening, defects and osteophytes in the various joint components. The true presence of the morphological changes was unanimously decided by consensus of three independent observers using naked-eye inspection. The accuracy for detection of the specific changes in each joint component was expressed as sensitivity and specificity values, whereas the accuracy for detection of morphological changes in general in the condyle and in the TMJ in toto was expressed as the number of matching radiographic and “gold standard” scores. Results: Up to 23% and 9% of the three joint components were reco...
TL;DR: This study reviews other methods of measuring LLD including full-length standing anteroposterior radiographs, computed tomography/digital localization image, and microdose digital scanography.
Abstract: The orthoroentgenogram, commonly known as the 'scanogram', continues to be the most widely used imaging technique for measuring limb length discrepancy (LLD). This study reviews other methods of measuring LLD including full-length standing anteroposterior radiographs, computed tomography/digital localization image, and microdose digital scanography. We present seven cases that demonstrate the pitfalls of scanograms as compared with full-length standing anteroposterior radiographs. Illustrative cases provide the rationale for the clinician managing LLD on a regular basis to utilize full-length standing anteroposterior radiographs as the instrument that will provide the most clinically relevant information.
TL;DR: Good correlation in total limb length measurements between this new technique and spot scanography was noted in 24 patients, and CT digital radiography should be the preferred method for evaluation for limb length discrepancy, particularly in children, because of the simple technique and lowering of radiation dose.
Abstract: CT digital radiography is a new accurate technique for measuring leg length discrepancy. It is easily performed on commercially available equipment with a radiation dose of 3-6 times less than the conventional technique. Because of the short time required to complete the examination, charges are comparable with those for existing procedures. Good correlation in total limb length measurements between this new technique and spot scanography was noted in 24 patients. CT digital radiography should be the preferred method for evaluation for limb length discrepancy, particularly in children, because of the simple technique and lowering of radiation dose.
TL;DR: The technique allows this to be measured accurately with the foot in the same relationship to the tibia as in the standing position, with 50 to 100 times less radiation than orthoroentgenography.
Abstract: We describe a technique for the accurate measurement of total leg length, including heel height. Computerised tomography (CT) can be used to measure the length of each tibia and femur (Helms and McCarthy 1984) but this technique cannot measure discrepancy of leg length distal to the ankle. The heel height may be a significant component of total discrepancy. Our technique allows this to be measured accurately with the foot in the same relationship to the tibia as in the standing position. It is a quick method with 50 to 100 times less radiation than orthoroentgenography (Green, Wyatt and Anderson 1946).
TL;DR: The art of measuring limb length inequality is an area both in orthopaedic and radiological circles that has been largely ignored in the recent past.