Background: Acetabular Retroversion (AR) is a hip disorder and one of the causes of pain in this area. Evaluation of positive Cross Over sign (COS) on AP X-Rays of the hip is currently the best method of diagnosis of AR. Several studies have measured co-existence of Ischial spine sign (ISS) in patients with AR. In this study we evaluated the diagnostic value of ISS in confirmation of AR and compared it with the diagnostic value of COS. Methods: In this study, 4120 AP hip X-Rays from Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, were studied. Based on radiologic criteria, 1180 X-Rays were considered as standards and evaluated for ISS, COS and PWS (Posterior Wall sign). Data analysis was done for correlation between ISS and COS. Results: A total of 1180 out of 4120 X-Rays were considered as standard; among which, 86 were diagnosed with AR based on positive COS in presence of PWS. Both ISS and COS were positive concurrently in 69 X-Rays. ISS was positive in absence of COS in 11 X-rays. No significant difference in diagnostic value for diagnosis of acetabular retroversion was found between ISS and COS (P<0. 05). Conclusion: According to our results, both ISS and COS signs can be employed for diagnosis of AR (acetabular retroversion). Considering the absence of a significant difference between these two signs in confirmation of AR, it can be perceived that the diagnostic value of ISS in confirmation of AR is equal to COS. Validation of the mentioned results requires further studies.

Background: Osteoid osteoma is a benign tumor that occurs in the spine in 10-20% of cases. Tumor presents with pain and/or deformity and usually causes torticoli in the cervical spine, and C-shape painful scoliosis is the most common presentation in the thoracic and lumbar spine.Methods: We studied 19 patients with established osteoid osteoma of the spine and reviewed their symptoms, site of involvement, imaging and treatment options. We also followed patients to determine the recurrence of tumor and outcome of deformity after tumor excision.Findings: Painful torticoli was the most common presentation of osteoid osteoma in the cervical spine (75%). In thoracic and lumbar lesions, painful scoliosis was the most common presentation (80%) but the tumor can be a painful condition in spine or even only a deformity. Typical night pain was seen in 9 patients. Tumor excision was the curative treatment although 3 patients needed posterior fusion because of scoliosis curve progression after tumor excision.Conclusion: Pain is the most common presentation of osteoid osteoma in spine and is often accompanied by deformity. Whole. body isotope bone scan and CT scan can help in making the diagnosis. In patientswithcurveCobbanglemorethan40 degreesatI the time of tumor excision, posterior spinal fusion is required.

Background & Objectives: In case of inappropriateness of the dimensions of chairs or when users feel pain and pressure in their lumbar region due to poor posture, damage to the spine can be prevented using some additional supports. The aim of this study was ergonomic evaluation of one of these supportive products named “spine Fit”.Methods: In this descriptive and cross-sectional study, in the first stage, five ergonomists evaluated the product regarding its dimension, adjustability, material, conformity, and manufacturer claims. Then, three groups of workers including office workers, office workers with low back pain, and bus drivers filled out a self-administered questionnaire after using spine Fit.Results: For the first stage, an acceptable adjustability and dimension was found. Conformity for different kinds of office and bus seats was mostly fair. Findings from the second stage revealed that the subjects in three groups were satisfied regarding seats comfort and ease of use. Concerning the conformity of spine Fit, it was in good level among office workers, while different levels of conformity were observed by drivers of different models of bus.Conclusion: spine Fit supports back region based on its supportive role in pelvis, lumbar vertebrae column and thoracic spine. Moreover, spine Fit features that reduce sweating can improve individuals’ convenience.

Considering the applicability of pelvic dimensions, its special properties and probably not matching the general standards, this study was performed on medical record of referrals of the Ayatollah Taleghani hospital during the year 1998.The descriptive protocol of this study was performed on the radiographic records of 103 patients. For this purpose the non-pregnant cases at an age range from 25 to 40 years old with no sign of disturbance and musculoskeletal system were selected. The records were prepared in an antero-posterior view and the bone landmarks were very obvious, otherwise they were not chosen. The parameters included: the distance between two antero-superior spine of the pelvis, transverse diameter of the inlet, oblique diameter of the upper inlet, the distance between two Ischial spines, infrapubic angle, sacral width, height of sacroiliacjoint, height of the symphysis pubis, diameter of the pubic disk, acetabular diameter and the distance between acetabular anterior margin and symphysis pubis. The results were expressed as Mean±SE, CI and CV and compared to the American and Chinese standards with student Hest. The results showed that in Iranian women, there existed a significant difference for the transverse diameter of the pelvic inlet (14.9±11mm) compared to Chinese women. In addition, the distance between two Ischial spines was 11.2±8.2mm.It is concluded that there is no match among Iranian, Chinese and American women for pelvic dimensions that can be related to racial, cultural and nutritional factors. Therefore it is recommended to carry out more researched to obtain a general standard for Iranian women.

In this study, a new sign for clinical diagnosis of acute appendicitis is introduced. The study was performed on a sample of 250 cases simply selected from the patients with acute appendicitis admitted to Al-Zahra Hospital of Isfahan. Before operation, the patients were evaluated for this sign in order to. assess its predictive value in diagnosis of acute appendicitis. Following the intervention, the appendix was sent to the department of pathology to confirm the diagnosis. Abdominal examinations prior to operation included checking the superficial and deep tenderness, rebound tenderness, Rovsing and the new sign. To check the new sign, while the patient was lying in a supine position, then the physician places his left hand below the right costovertebral angle and inflicts a few short thrusts on the flank. In case, the patient feels pain in front of the lower abdomen, and with his/her hand locates the pain, it will be considered as a positive sign. Then predictive value, sensitivity and specificity of the new sign in diagnosing acute appendicitis were assessed. For comparison of the qualitative variables chi-test and for the quantitative variables Hest were employed. The results showed that sensitivity of the new sign is 67%, its specificity is 35%, its negative predictive value is 32% and its positive predictive value is 72%. This new sign here after named (BEHDAD sign) can, along with other signs, helps to diagnose acute appendicitis.

Background: Increased right ventricle-to-left ventricle (RV/LV) ratio on computed tomography pulmonary angiography (CTPA) has been reported as a poor prognostic indicator in patients with acute pulmonary embolism (PE). It has also been reported that pulmonary vein sign (PVS) on CTPA is a rare finding of PE. Objectives: To evaluate PVS on CTPA and unenhanced magnetic resonance imaging (MRI) in patients with PE suspicion. We also aimed to investigate the relationship between the severity of PE and presence of PVS, RV/LV ratio and combination of these two on unenhanced MRI. Patients and Methods: One-hundred-twelve patients with PE suspicion who underwent CTPA and unenhanced-MRI [steady state free precession (SSFP)] within the first 48-hours constituted the study group. All CTPA images were evaluated for the presence, location and severity of PE by observer-1. Two observers (observer-2 and 3), independently evaluated unenhanced-MR images for the presence of PVS without knowing the results of CTPA. Then, these 2 observers reviewed the CTPA and MRI images together with observer-4 to reach the final consensus for the presence of PVS and measurement of RV/LV ratio. Cohen’ s Kappa analysis was used to assess the agreement between observers. Relationship between the mean PE index and imaging findings (PVS, RV/LV) were calculated. Results: Presence of PVS on CT or MRI is significantly correlated with PE index and patients with PVS had more severe PE than those without. Presence of both PVS and RV/LV ratio > 1 on MRI indicates more severe pulmonary embolism than absence of PVS or RV/LV ratio > 1. There was a very good agreement for the detection of PVS between two observers on unenhanced MRI. Conclusion: PVS on CTPA or unenhanced MRI can be used as a sign of severe PE and it may also be an indicator of right heart dysfunction.