Introduction: Periodontal disease affects more than half of the population in Colombia and is estimated to be one of the leading causes of oral morbidity. Diagnostic aids that allow the evaluation of its extension and severity are of importance since this will provide reliable tools to quantify the severity of the problem. Objective: To determine the inter-examiner agreement for the detection of radiographic findings in patients with localized chronic periodontitis using conventional periapical radiography. Methods: Study of diagnostic tests including patients with localized chronic periodontitis, the tooth with the worst clinical insertion level and a single conventional radiograph per dental organ using parallelism technique. The radiographic evaluations were performed by two independent and blinded evaluators for the findings: lamina dura, bone defects and type of defect. The agreement obtained was estimated through Cohen’s Kappa. Results: A total of 125 radiographs were taken. The mean age was 38.8 ± 9.9, and 61.6% were women. Concordance for lamina dura was 0.08 (95% CI: -0.04–0.21), bone defects 1.00 (95% CI: 1.00–1.00); type of defect present 0.31 (95% CI: 0.29–0.38). Conclusions: Concordance was evaluated as null, almost perfect and acceptable for the findings lamina dura, presence of bone defects and type of defect respectively. For some findings and given the importance of the diagnostic and therapeutic processes, more accurate evaluations are needed which would result in a higher degree of agreement.

Background: Multiple sclerosis is often a longitudinal disease continuum with an initial relapsing-remitting phase (RRMS) and later secondary progression (SPMS). Most currently approved therapies are not sufficiently effective in SPMS. Early detection of SPMS conversion is therefore critical for therapy selection. Important decision-making tools may include testing of partial cognitive performance and magnetic resonance imaging (MRI). Aim of the work: To demonstrate the importance of cognitive testing and MRI for the prediction and detection of SPMS conversion. Elaboration of strategies for follow-up and therapy management in practice, especially in outpatient care. Material and methods: Review based on an unsystematic literature search. Results: Standardized cognitive testing can be helpful for early SPMS diagnosis and facilitate progression assessment. Annual use of sensitive screening tests such as Symbol Digit Modalities Test (SDMT) and Brief Visual Memory Test-Revised (BVMT-R) or the Brief International Cognitive Assessment for MS (BICAMS) test battery is recommended. Persistent inflammatory activity on MRI in the first three years of disease and the presence of cortical lesions are predictive of SPMS conversion. Standardized MRI monitoring for features of progressive MS can support clinically and neurocognitively based suspicion of SPMS. Discussion: Interdisciplinary care of MS patients by clinically skilled neurologists, supported by neuropsychological testing and MRI, has a high value for SPMS prediction and diagnosis. The latter allows early conversion to appropriate therapies, as SPMS requires different interventions than RRMS. After drug switching, clinical, neuropsychological, and imaging vigilance allows stringent monitoring for neuroinflammatory and degenerative activity as well as treatment complications.

Gout is an arthritis characterized by the deposition of sodium monoacid crystals in the synovial membrane, articular cartilage, and periarticular tissues that leads to an inflamatory process. In most cases, the diagnosis is established by clinical criteria and analysis of the synovial fluid for MSU crystals. However, gout may manifest in atypical ways and make diagnosis difficult. In these situations, imaging studies play a fundamental role in helping to confirm the diagnosis or even exclude other differential diagnoses. Conventional radiography is still the most commonly used method in the follow-up of these patients, but it is a very insensitive test, because it only detects late changes. In recent years, advances in imaging methods have emerged in relation to gout. Ultrasound has proven to be a highly accurate test in the diagnosis of gout, identifying MSU deposits in articular cartilage and periarticular tissues, and detecting and characterizing tophi, tendinopathies, and tophi enthesopathies. Computed tomography is an excellent exam for the detection of bone erosions and evaluation of spinal involvement. Dual-energy computed tomography, a new method that provides information on the chemical composition of tissues, allows identification of MSU deposits with high accuracy. MRI can be useful in the evaluation of deep tissues not accessible by ultrasound. In addition to diagnosis, with the emergence of drugs that aim to reduce the tophaceous burden, imaging examinations become a useful tool in the follow-up treatment of gout patients.

Imaging technology plays a key role in guiding endovascular treatment of aortic aneurysm, especially in the complex thoracoabdominal aorta. The combination of high quality images with a sterile and functional environment in the surgical suite can reduce contrast and radiation exposure for both patient and operator, in addition to better outcomes. This presentation aims to describe the current use of this technique, combining angiotomography and intraoperative cone beam computed tomography, image “fusion” and intravascular ultrasound, to guide procedures and thus improve the intraoperative success rate and reduce the need for reoperation. On the other hand, a procedure is described to create customized 3D templates with the high-definition images of the patient’s arterial anatomy, which serve as specific guides for making fenestrated stents in the operating room. These customized fenestration templates could expand the number of patients with complex aneurysms treated minimally invasively.

Introduction: Chest trauma has a high incidence and pneumothorax is the most frequent finding. The literature is scarce on what to do with asymptomatic patients with pneumothorax due to penetrating chest trauma. The aim of this study was to evaluate what are the findings of the control radiography of patients with penetrating chest trauma who are not initially taken to surgery, and their usefulness in determining the need for further treatment. Methods: A retrospective cohort study was performed, including patients older than 15 years who were admitted for penetrating chest trauma between January 2015 and December 2017 and who did not require initial surgical management. We analyzed the results of chest radiography, the time of its acquisition, and the behavior decided according to the findings in patients initially left under observation. Results: A total of 1,554 patients were included, whose average age was 30 years, 92.5% were male and 97% had a sharp weapon wound. Of these, 186 (51.5%) had no alterations in their initial X-ray, 142 had pneumothorax less than 30% and 33 had pneumothorax greater than 30 %, hemopneumothorax or hemothorax. Closed thoracostomy was required as the final procedure in 78 cases, sternotomy or thoracotomy in 2 cases and discharged in 281. Conclusion: In asymptomatic patients with small or moderate pneumothorax and no other significant lesions, longer observation times, radiographs and closed thoracostomy may be unnecessary.