Browsing by Author "Prithishkumar, Ivan James"

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Estimating aspect ratio of the distal femur and proximal tibia in the Emirati population from MRI scans of the knee: a preliminary experience
(2023) Prithishkumar, Ivan James
Abstract: Size and shape of knee implants play an important role in the success of total knee arthroplasty. Several studies have identified anthropometric differences of the distal femur and proximal tibia between the genders and ethnicities. Ill-fitting prosthesis can cause overhang or under-ft resulting in persistence of pain, periprosthetic fracture and decreased range of motion. The purpose of this study was to estimate the aspect ratio of distal femur and proximal tibia in the Emirati population and determine whether gender differences exist within this group. Magnetic resonance imaging datasets of unilateral knees scans performed on adult Emirati patients at a tertiary care hospital were retrospectively examined. Knee parameters were obtained from 65 males and 46 females (n= 111). Females showed significantly smaller AP and ML dimensions of distal femur and lower aspect ratios compared to males (p< 0.001). Proximal tibial dimensions (AP and ML) of Emirati women are also significantly smaller compared to men. However, aspect ratio of proximal tibia did not show gender variation (p= 0.956) within the Emirati population. Emirati knees showed significant gender differences in bony dimensions and aspect ratio of the knee, and also have smaller aspect ratios when compared with most other population groups.
Estimation of Anatomical Dimensions of the Thorax from Computed Tomography Images of the Adult ‎and Pediatric Indian Population for Developing Optimal Radiological Protocols
(2021) Nathan, Vandana; Prithishkumar, Ivan James
Purpose:‎ Ionizing radiation has been extensively used for medical diagnosis since its discovery in 1895; however, ‎excessive use can lead to deleterious effects. Prior knowledge on radiological protocols based on ‎simulations would be a practical tool for optimal use of radiation.‎ Materials and Methods: Scan length of the thorax was measured from computed tomography (CT) topographic images and ‎cross‑sections at three levels of the thorax were measured from tomographic images of 500 adults and ‎‎340 children who had undergone CT thorax examinations using Centricity workstation software. The ‎effective diameter (ED) of the thorax was calculated from anterio‑posterior (AP) and transverse ‎anatomical dimensions. Results: A 17% increase in scan length was observed for 6–10 years age group ‎compared to 0–5 years, whereas there was marginal increase for 11–15 years of age. A 11.5% increase ‎was observed for 16–18 years compared to 11‑15 years age group. The cross‑sectional phantom ‎dimensions were calculated from ED measurements obtained from three regions of the thorax. ‎ Conclusions: This study has provided age‑ and gender‑specific reference scan lengths, AP and transverse ‎dimensions and ED for radiological examinations of the thorax. This information is useful to develop ‎age‑ and gender‑specific preset protocols and fabricate phantoms of the thorax for the pediatric and ‎adult Indian population.‎
A novel reconstructive approach of the lumbar vertebral column from 2D MRI to 3D models
(2022-11) Naidoo, Nerissa; Lakshmanan, Jeyaseelan; Prithishkumar, Ivan James
Introduction: Low back pain (LBP), arising from the lumbar vertebral column (LVC), is a global burden, ranking highest in terms of disability. In the United Arab Emirates (UAE), there is a high prevalence of LBP in the adult population. As MRI has emerged as the mainstay in assessment of LVC-related conditions, this study aimed to reconstruct reproducible 3D LVC MRI models from 2D MRI scans. Methods: Following the extraction of serial 2D MRI scan slices from an existing image database, ffty 3D MRI models (n = 50) were retrospectively reconstructed (Mimics Innovation Suite ®) and analyzed through the bootstrapping technique. Results: Lumbar vertebral bodies depicted kidney and oval shapes, with an increasing frequency of the former traced from L1 to L5. Traction (10%) and claw (14%) osteophyte types were noted. The inferior rims of L2 (2%) and L4 (4%) presented with the co-existence of both osteophyte types, which was reflective of the same degenerative process. Morphometric dimensions of L1 were also determined: Anterior vertebral height: 29.6 ± 3.5 mm (28.6–30.5 mm); Posterior vertebral height: 26.8 ± 3.1 mm (25.9–29.6 mm); Superior vertebral width: 40.6 ± 3.8 mm (39.6–41.6 mm); Intervertebral disc height between L1 and L2: 15.9 ± 6.3 mm (14.3–17.7 mm). Conclusion: A proof-of-concept in the reconstructive approach of the LVC was established, which introduces a process through which a normative simulated dataset can be obtained in the extended population. Additionally, these values will assist to detect structural disproportions and changes and contribute to pre-operative planning and artificial intervertebral disc implant design.
Prevalence of the additional head of quadriceps femoris in the South Indian population: a cadaveric and radiological study
(2021) Prithishkumar, Ivan James
Abstract: Quadriceps femoris is an extensor muscle in the anterior compartment of thigh and is traditionally taught to be composed of four heads. Recently, there is an increased interest in the occurrence of an additional muscle head of quadriceps femoris. But scientifc knowledge regarding its incidence is lacking in the South Indian population. This study was done to confrm the presence of the additional head by routine anatomic dissection and radiological imaging techniques. Forty-one formalin fxed human cadaveric lower limbs were dissected and the morphology of the additional head was noted. Retrospective analysis of 88 MRI images of patients was done. The additional muscle head was present in 43.9% of the cadaveric lower limbs and was consistently located between the vastus lateralis and vastus intermedius. It originated from variable portions of the greater trochanter, intertrochanteric line, lateral lip of linea aspera and lateral surface of the shaft of femur and inserted either as a muscle belly or as an aponeurosis into the vastus intermedius (55.6%), vastus lateralis (22.2%) or directly into the base of the patella. It received its vascular supply from branches of the lateral circumfex femoral artery and was innervated by branches from the posterior division of the femoral nerve. In addition, the additional muscle head was identifed by MRI and its incidence was reported to be 30.68% for the frst time in living subjects. The result of this study provides additional information in understanding the morphology of the quadriceps femoris muscle.