Vertebral body shape annotation can be substantially automated on lumbar radiographs. However, an occasional manual correction may be required, typically with either severe fractures, or when there is a high degree of projectional tilting or scoliosis. The located detailed shapes may enable the development of more powerful quantitative classifiers of osteoporotic vertebral fracture.

Abstract. The aim of the work is to provide a fully automatic method of segmenting vertebrae in spinal radiographs. This is of clinical relevance to the diagnosis of osteoporosis by vertebral fracture assessment, and to grading incident fractures in clinical trials. We use a parts based model of small vertebral patches (e.g. corners). Many potential candidates are found in a global search using multi-resolution normalised correlation. The ambiguity in the possible solution is resolved by applying a graphical model of the connections between parts, and applying geometric constraints. The resulting graph optimisation problem is solved using loopy belief propagation.The minimum cost solution is used to initialise a second phase of active appearance model search. The method is applied to a clinical data set of computed radiography images of lumbar spines. The accuracy of this fully automatic method is assessed by comparing the results to a gold standard of manual annotation by expert radiologists.

Post-void alarm systems to monitor bedwetting in nocturnal enuresis (NE) have been deemed unsatisfactory. The aim of this study is to develop a safe, comfortable and non-invasive pre-void wearable alarm and associated technologies using advanced mechatronics. Each stage of development includes patient and public involvement and engagement (PPI). The early stages of the development involved children with and without NE (and parents) who were tested at a hospital under the supervision of physicians, radiologists, psychologists, and nurses. The readings of the wearable device were simultaneously compared with B-mode images and measurements, acquired from a conventional ultrasound device, and were found to correlate highly. The results showed that determining imminent voiding need is viable using non-invasive sensors. Following on from "proof of concept," a bespoke advanced mechatronics device has been developed. The device houses custom electronics, an ultrasound system, intelligent software, a user-friendly smartphone application, bedside alarm box, and a dedicated undergarment, along with a self-adhesive gel pad-designed to keep the MEMS sensors aligned with the abdomen. Testing of the device with phantoms and volunteers has been successful in determining bladder volume and associated voiding need. Five miniaturised, and therefore more ergonomic, versions of the device are being developed, with an enabled connection to the cloud platform for location independent control and monitoring. Thereafter, the enhanced device will be tested with children with NE at their homes for 14 weeks, to gain feedback relating to wearability and data collection involving the cloud platform. Keywords Bedwetting • Ultrasound • Bladder • Nocturnal enuresis • Advanced mechatronics • MEMS • Wearable health monitoring devices 1 Introduction Nocturnal enuresis (NE), i.e. bedwetting, is the involuntary discharge of urine at night in a child in the absence of congenital or acquired defects of the central nervous system Electronic supplementary material The online version of this article (

Primary pleuropulmonary synovial sarcoma is a rare malignancy. Commonly described radiologic features in the literature include pleural disease and/or effusion, lack of calcification and high uptake on positron emission tomography computerised tomography. A 68-year-old woman presented with a 3-month history of cough. Imaging studies showed a right upper lobe mass with internal foci of calcification, endobronchial extension, and low fluorodeoxyglucose avidity on positron emission tomography computerised tomography, leading to an initial diagnosis of carcinoid tumor. However, histologic specimens suggested an unexpected diagnosis of aggressive synovial sarcoma, and the case was referred to the sarcoma MDT. Metastatic synovial sarcoma was ruled out, and radical surgical excision of the lesion was performed. This article highlights the multiple atypical features of primary pleuropulmonary synovial sarcoma as seen in this case and reviews imaging findings described in the literature. Radiologists should be aware of this unusual yet aggressive type of sarcoma.

Sarcoidosis is an idiopathic inflammatory disorder characterized by the presence of non-caseating tissue granulomas most commonly affecting lungs, lymph nodes and skin. Sarcoid skeletal involvement is relatively uncommon and in particular tenosynovitis. We describe an unusual case of sarcoidosis presenting with granulomatous tenosynovitis as the only manifestation of the disease, illustrating the radiological findings on different modalities followed by a review of the literature. Radiologists and clinicians should be aware of tenosynovitis as a manifestation of sarcoidosis as early and therefore appropriate treatment significantly alters patient's outcome and prognosis.

No abstract

Background:Although subspecialist orthopaedic surgeons usually request Magnetic Resonance Arthrogram (MRA) examinations, some orthopaedic surgeons may request this examination for a body part that is different from their subspecialty. The purpose of the study is to compare the MRA and the clinical findings in the subspecialist and non-subspecialist groups.Method:Retrospective analysis of MRA examinations over a 6-month period. Findings were compared with the clinical information.Results:There were 144 examinations (69 shoulder, 42 wrist and 33 hip). 85% of these were subspecialist referrals; 60% of them showed findings compatible with the clinical diagnosis. 15% of the MRA examinations were non-subspecialist referrals; 52% of them correlated with the clinical findings.Overall, clinical information agreed with MRA findings for shoulder labral tears, hip labral tears and wrist triangular fibrocartilage complex tears in 63.3%, 64.5% and 61.5% respectively. The subspecialist group were more accurate than the non-subspecialist group in diagnosing hip labral tears (68% vs. 50%) and triangular fibrocartilage complex tears (62.5% vs. 50%). On the contrary, shoulder MRA and clinical findings correlated better in the non-subspecialist group (77.8%) compared to the subspecialist group (63.3%). However, the small number of requests generated by the non-subspecialist group may affect the results. Suspected scapholunate ligament injury showed low correlation with MRA at 26.7% (33.3% in the subspecialist group and 0% in the non-subspecialist group).Conclusion:Generally, the clinical findings are more accurate in the subspecialist referrals when compared to MRA findings and therefore a subspecialist referral is preferred. The low agreement between clinically suspected scapholunate ligament injuries and wrist MRA probably reflects the relative difficulty in establishing this diagnosis clinically.

No abstract