Background The EOS™ X-ray machine, based on a Nobel prize-winning invention in physics in the field of particle detection, is capable of a simultaneous capture of biplanar X-ray images by slot scanning of the whole body in an upright, physiological load-bearing position, using ultralow radiation doses. The simultaneous capture of spatially calibrated anterioposterior and lateral images provides a three-dimensional (3D) surface reconstruction of the skeletal system using a special software. Parts of the skeletal system in X-ray images and 3D-reconstructed models appear in true 1:1 scale for size and volume, thus spinal and vertebral parameters, lower limb axis lengths and angles, as well as any relevant clinical parameters in orthopaedic practice can be very precisely measured and calculated. Visualisation of 3D reconstructed models in various views by sterEOS 3D software enables presentation of top view images to help analyse rotational conditions of lower limbs, joints and spine deformities in the horizontal plane, providing revolutionary novel possibilities in orthopaedic surgery, especially in spine surgery. Approach and conclusions Our department has been extensively using the very first commercially available EOS™ imaging system worldwide for routine orthopaedic diagnostics since June 2007. During this period of about 4.5 years, more than 5,700 standard examinations have been carried out, about a third of them in spine deformity cases and the rest in lower limb orthopaedic cases. In this mini-review, general principles and uses of this groundbreaking integrated orthopaedic solution is reviewed with a few highlighted examples from our own clinical practice.

Evaluation of the structure-function relationship in normal subjects and those with PPG or POAG showed strong curvilinear regression in POAG eyes with PSD >1.9 dB and RNFL AVG thickness below 70 microm, whereas no correlation was detectable above these values.

Scoliosis is a multifactorial three-dimensional (3D) spinal deformity with integral and directly related vertebral deviations in the coronal, sagittal and horizontal planes. Current classification and diagnostic methods rely on two-dimensional (2D) frontal and lateral X-ray images; no routine methods are available for the visualization and quantitative evaluation of deviations in the horizontal plane. The EOS 2D/3D system presented here is a new, low-dose, orthopedic radiodiagnostic device based on Nobel prize-winning X-ray detection technology with special software for 3D surface reconstruction capabilities that finally led to a breakthrough in scoliosis diagnosis with high-quality, realistic 3D visualization and accurate quantitative parametric analysis. A new concept introducing vertebra vectors and vertebra vector parametric calculations is introduced that furnishes simplified visual and intelligible mathematical information facilitating interpretation of EOS 2D/3D data, especially with regard to the horizontal plane top view images. The concept is demonstrated by a reported scoliotic case that was readily characterized through information derived from vertebra vectors alone, supplemented with the current angulation measurement methods in the coronal and sagittal planes and axial vertebral rotation measurements in the horizontal plane, with a calibrated 3D coordinate system suitable for inter-individual comparisons. The new concept of vertebra vectors may serve as a basis for a truly 3D classification of scoliosis.

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EOS 2D/3D with its sterEOS 3D reconstruction is useful for a comprehensive 3D examination of the lower limb. In the near future it may be suitable for daily routine diagnostics of orthopedic lower limb deformities as a primary examination method.