This audit analysed the Tanner and Whitehouse II twenty bone (TW2) method of bone age assessment which was used in our department, and compared it with the Greulich and Pyle (GP) method. 50 previous bone ages were independently re-calculated by each of three registrars using both techniques, with the time taken to perform each assessment being recorded. For each method the interobserver variation was analysed in terms of the spread of results. The intraobserver variation in TW2 was determined by comparing the bone age originally reported with that subsequently calculated on the same film by the same registrar. The average spread of results was 0.74 years for TW2 method, and 0.96 years for the GP method and this difference is not statistically significant at the 5% level. The average intraobserver variation to TW2 was 0.33 years, but with 95% confidence limits of -0.87 to +1.53 years. The average time taken was 7.9 min for TW2 and 1.4 min for GP assessments. It was concluded that the GP method gave similar reproducibility and was faster than the TW2 method. Following clinical discussion the routine departmental bone age assessment method was changed from the TW2 to the GP method.

Tibial plateau widening in the setting of fracture is an indication for surgical treatment, and restoring width is an important goal of surgery. In order to identify and correct pathological widening, the width of the normal tibial plateau must first be defined. The aim of this study was to establish normative data for the width of the tibial plateau relative to the distal femur to enable surgeons to identify and correct pathological widening in the setting of tibial plateau fracture. Fifty-one uninjured anteroposterior (AP) knee radiographs and 11 XR and CT scans of lateral tibial plateau fractures were retrospectively reviewed. The distances measured included maximal distal femoral width, femoral articular width, tibial articular width, and lateral plateau widening. On average, lateral plateau widening was +0.02 ± 2.03 mm, indicating that the most lateral aspect of the tibial plateau is collinear with the most lateral aspect of the lateral epicondyle of the femur. In the fracture population, average widening was 7.13 ± 3.59 mm on XR and 6.57 ± 3.34 mm on CT, with an absolute difference between XR and CT of 1.19 ± 0.66 mm. In conclusion, this study is the first to define the radiographic anatomy of the proximal tibia quantitatively. In the setting of tibial plateau fracture, residual widening of 2.1 mm could be within normal variation. However, the authors consider widening >2.1 mm pathological. These values can be used for assessing pathological widening of tibial plateau fractures. Clin. Anat. 31:688-692, 2018. © 2018 Wiley Periodicals, Inc.

Background Airline crew are exposed to ionizing radiation as part of their occupation and have a documented increased risk of melanoma and cataracts. However, whether their occupation predisposes them to an increased risk of thyroid cancer is not established. The purpose of this systematic review and meta-analysis was to assess the risk of thyroid cancer in airline cockpit and cabin crew compared with the general population. Methods The MEDLINE database accessed via PubMed and Cochrane Database were searched. We included cohort studies reporting the standardized incidence ratio (SIR) or standardized mortality ratio (SMR) of thyroid cancers in any flight-based occupation. Results Of the 1777 citations retrieved in PubMed, eight studies with a total of 243,088 aircrew members and over 3,334,114 person-years of follow-up were included in this meta-analysis. No relevant studies were identified on Cochrane Database. The overall summary SIR of participants in any flight-based occupation was 1.11 (95% CI, 0.79–1.57; p = 0.613; 6 records). The summary SIR for cockpit crew was 1.21 (95% CI, 0.75–1.95; p = 0.383; 4 records) and the summary SIR for cabin crew was 1.00 (95% CI, 0.60–1.66; p = 0.646; 2 records). The overall summary standardized mortality ratio for airline crew was 1.19 (95% CI, 0.59–2.39; p = 0.773; 2 records). Conclusion Airline crew were not found to have a significantly elevated risk of thyroid cancer incidence or mortality relative to the general population. Future research should capitalize on the growing occupational cohort dataset and employ innovative methods to quantify lifetime radiation exposure to further assess thyroid cancer risk in airline crew. Electronic supplementary material The online version of this article (10.1186/s41199-018-0034-8) contains supplementary material, which is available to authorized users.

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