The purpose of this study was to assess the value of calculated fetal weight in the detection of the small-for-menstrual-age fetus. An ultrasound screening scan was performed on 1624 singleton pregnancies at 30 weeks to 36 weeks, menstrual age. Head, abdomen, and femur diaphysis measurements were recorded and used to estimate fetal weight. These and other more widely used parameters were used to predict birth weight below the 10th percentile for menstrual age. Estimated fetal weight at 34 weeks achieved sensitivity of 100% and specificity of 70%, the best result for any parameter. Specificity is improved using growth measurements.
Accurate diagnosis is essential for the effective management of suspected bone infection. Current imaging techniques have had limited success and further work is required. Although white cell labelling techniques have been available for many years the radiopharmaceuticals employed have disadvantages, particularly in their availability and suitability for imaging. These problems have been overcome by the use of 99Tcm-HMPAO as an in vitro leukocyte labelling agent. The aims of this study were to assess retrospectively its role and accuracy in imaging orthopaedic infection and to compare the results with three-phase bone imaging. 30 patients with suspected bone infection underwent three-phase methylene diphosphonate (MDP) bone imaging and labelled leukocyte imaging on separate occasions. 16 bone scans were positive for infection, of which 14 were subsequently confirmed, and there were no false negatives. There were no false positive white cell studies and only one infection was not identified. 99Tcm-HMPAO white cell imaging has been shown to be an accurate technique for the diagnosis of bone infection but should be performed only following a positive finding on three-phase bone scanning, since the latter is highly sensitive but significantly less expensive, making it a more appropriate screening procedure.
Summary. A method for estimating fetal weight by calculating an approximate fetal volume from abdominal area, head area and femur length has been developed. Birthweights were calculated within 48 h before delivery for 434 patients, using this method and two other methods already in widespread use. Statistical analysis of the three sets of predictions gave standard deviations of 297 g for the new method, compared with 323 g and 342 g for the other methods. Further analysis of the data showed that estimates closest to the true birthweight were obtained in 41% of cases by using the new method, and in 33% and 26% of cases using the other methods.
We thank you for the opportunity to respond to the interesting letter from Dr Wilson concerning our recent article (Copping et al, 1992).
The group of patients included in the study were those with suspected latent infection. They presented with pain, no elevation of temperature and subsequent negative blood tests. In our opinion, aspiration is not the primary investigation of choice for such patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.