Evidence map›Paper›PMID 30242446›Full record

ArticleSkeletal radiology2019

Cone-beam CT measurements of distal tibio-fibular syndesmosis in asymptomatic uninjured ankles: does weight-bearing matter?

Delaram Shakoor, Greg M Osgood, Michael Brehler, Wojciech B Zbijewski, Cesar de Cesar Netto, Babar Shafiq, Jakrapong Orapin, Gaurav K Thawait, Lew C Shon, Shadpour Demehri

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Article in Skeletal radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed.

  1. Article
  2. Ankle osteoarthritis: Toward new understanding and opportunities for prevention and intervention.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2024
    Review
  3. Article
  4. Review
  5. Article
  6. Article
  7. Application of external torque enhances the detection of subtle syndesmotic ankle instability in a weight-bearing CT.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023
    Article
  8. Article
  9. Review
  10. Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Delaram ShakoorRussell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD, USA. delaramshakoor@mail.com.
Greg M OsgoodDepartment of Orthopedic Surgery, Johns Hopkins University, Baltimore, MD, USA.
Michael BrehlerDepartment of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA.
Wojciech B ZbijewskiDepartment of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA.
Cesar de Cesar NettoDepartment of Orthopedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.
Babar ShafiqDepartment of Orthopedic Surgery, Johns Hopkins University, Baltimore, MD, USA.
Jakrapong OrapinDepartment of Orthopedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.
Gaurav K ThawaitRussell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD, USA.
Lew C ShonDepartment of Orthopedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.
Shadpour DemehriRussell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the influence of weight-bearing (WB) load in standard axial ankle syndesmotic measurements using cone beam CT (CBCT) examination of asymptomatic uninjured ankles. MATERIALS AND

methodsIn this IRB approved, prospective study, patients with previous unilateral ankle fractures were recruited. We simultaneously scanned the injured ankles and asymptomatic contralateral ankles of 27 patients in both WB and NWB modes. For this study, only asymptomatic contralateral ankles with normal plain radiographs were included. Twelve standardized syndesmosis measurements at two axial planes (10 mm above the tibial plafond and 5 mm below the talar dome) were obtained by two expert readers using a custom CBCT viewer with the capability for geometric measurements between user-identified anatomical landmarks. Inter-reader reliability between two readers was obtained using the intra-class correlation coefficient (ICC). We compared the WB and NWB measurements using paired t test.

resultsSignificant agreement was observed between two readers for both WB and NWB measurements (p <0.05). ICC values for WB and NWB measurements had a range of 50-95 and 31-71 respectively. Mean values of the medial clear space on WB images (1.75, 95% confidence interval [95% CI]: 1.6, 1.9) were significantly lower than on NWB images (2.05, 95% CI: 1.8, 2.2) measurements (p <0.001). There was no significant difference between the remaining WB and NWB measurements.

conclusionMeasurements obtained from WB images are reliable. Except for the medial clear space, no significant difference in syndesmotic measurements were observed during the WB mode of CBCT acquisition, implying that the tibio-fibular relationship remains unchanged when the physiological axial weight-bearing load is applied.

Indexed as

Cone-Beam Computed TomographyAnkle JointFemaleHumansMaleMiddle AgedProspective StudiesReproducibility of ResultsWeight-BearingCone-beam CTMedial clear spaceNormal anklesSyndesmosisWeight-bearing

Identifiers

PMID30242446

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.