OBJECTIVE: To evaluate the bone mineral density variability in patients with systemic lupus erythematosus, before the beginning and at 30 and 60 days from the beginning of glucocorticoid therapy. MATERIALS AND METHODS: Fifteen premenopausal women with systemic lupus erythematosus were referred for bone densitometry before being submitted to glucocorticoid therapy. RESULTS: It was demonstrated that the bone mineral density in g/cm² in the lumbar spine presented a significant decrease in the span between the first analysis previously to the beginning of the glucocorticoid therapy and the third analysis after 60 days under therapy. On the other hand no significant difference was found in the femoral neck. CONCLUSION: The authors conclude that, at short term, rather than only at long term as previously reported by other authors, corticotherapy in patients with systemic lupus erythematosus results in a decrease in the bone mineral density in the lumbar spine.

Keywords: Bone densitometry, Premenopause, Systemic lupus erythematosus

OBJECTIVE: To compare the new normatization of bone densitometry reports on findings at the level of the lumbar spine (L1-L4) proposed by International Society for Clinical Densitometry (ISCD) in 2005, with the classification of World Health Organization (WHO) that was routinely been utilized since 1994. MATERIALS AND METHODS: Bone densitometry studies performed on the lumbar spine of 200 patients at Universidade Católica de Brasília and Hospital das Forças Armadas, Brasília, DF, Brazil, have been evaluated. Inclusion criteria were: female gender, age ranging between 20 and 49 years, and absence of spine morphological changes visualized on the images. The exclusion criteria were: women more than 50 years or menopausal women. RESULTS: Analyzing the bone densitometry reports under the WHO classification, 29 patients were found with osteoporosis, 76 with osteopenia and 95 within normality levels. On the other hand, according to the new ISCD 2005 classification, only 32 patients presented results "below the expected range for age", and 162 "within the expected range for age". CONCLUSION: Significant differences were found when comparing the traditional WHO densitometric classification versus the new one proposed by ISCD 2005. So, this new classification should be known and understood by physicians who request or perform bone densitometry studies, aiming at the correct interpretation, explanation and orientation to the patients.

Keywords: Densitometry, Osteoporosis, Spine, Bone density

OBJECTIVE: To develop of a software tool for evaluation and control of sensitometric curves. MATERIALS AND METHODS: A method was developed for obtaining high- and low-contrast films sensitometric values, with no need to define wedge steps. RESULTS: The software named Sensito was implemented and tested utilizing data of sensitometric strips from conventional radiology, hemodynamics, and mammography departments. The feasibility of analyzing sensitometric curves from these areas remained evidenced with no need of user-dependent adjustments, and with no deviation in the evaluated sensitometric parameters and variations. CONCLUSION: The software allows the creation of a database including sensitometric curves from different processors in a same institution, easily generating gamma curves of a register and constant charts of the evaluated sensitometric characteristics, constituting an important tool for sensitometric control.

Keywords: Automatic processor, Sensitometric curve, Sensitometry

OBJECTIVE: To study the interchangeability of the bone mineral density results between Hologic® dual energy x-ray absorptiometry (DEXA) and Cromox® computed dual energy conventional x-ray absorptiometry (CDEXA) equipments. MATERIALS AND METHODS: Thirty-eight femoral necks and 31 lumbar spines of 43 patients underwent bone mineral density measured by both equipments in a diagnostic imaging center. The Cromox® equipment was calibrated with a reference Cromox® phantom for bone absorptiometry. RESULTS: A strong correlation between results obtained from the two devices was found for each skeletal site. The linear correlation coefficient measured for the right femoral neck was r = 0.920, p < 0.0001, and r = 0.923, p < 0.0001 for the lumbar spine L2-L4 vertebrae. Considering the relevance of the Tscore result in the clinical practice for bone densitometry, the mean difference of the Tscore between devices was calculated, resulting in an arithmetic mean DTscore = 0.191 for hips and an arithmetic mean DTscore = 0.228 for the lumbar spines. The skeletal status is established according to the World Health Organization definition as normal, osteopenia or osteoporosis. The skeletal status concordance between devices was higher than 76% for hips and higher than 77% for spines; and higher than 96% when considering concordance in at least one of the two sites. CONCLUSION: The linear correlation coefficients obtained are very close to the international references among gold standard devices, reported as r > 0.95. For both sites, the arithmetic mean difference in Tscore between devices is low - least than the lowest significant variance.

Keywords: Dual energy x-ray absorptiometry, Dual energy radiographic absorptiometry, Computed x-ray densitometry, Correlation, Interchangeability

Central nervous system involvement is frequently reported in patients with systemic lupus erythematosus. Computed tomography and magnetic resonance imaging studies usually show brain atrophy, cerebral infarction and/or intracranial bleeding. Extensive intracranial calcification in patients with systemic lupus erythematosus is rare. We report a case of a patient with systemic lupus erythematosus who presented with seizures and massive basal ganglia calcification and mild calcifications in the frontal lobes, seen on the brain computed tomography scan. Magnetic resonance imaging showed hyperintensity on FLAIR images and hypointense signals on T2* gradient echo images in the basal ganglia.

Keywords: Systemic lupus erythematosus, Intracranial calcification, Computed tomography

Quality control of automatic processors is an important issue in the implementation of quality assurance programs in diagnostic radiology. A pilot program of quality control for automatic processors using the sensitometric method was implemented in the Radiodiagnosis Service of a University Hospital in Rio de Janeiro, RJ, Brazil. An initial survey of the darkrooms showed that they had high temperature and humidity and several light leaks; fog levels were excessively high requiring an increase in mAs of up to 24% to compensate for contrast loss; dry to dry processing time was out of control with errors of up to 56%; developer temperature was as high as 39°C (4°C higher than the recommended by the manufacturers); replenishment rates presented values as high as 417% above manufacturer's recommendations; and rejection rates of radiographic films were of the order of 21% in the mammography service. Sensitometric measurements performed before the implementation of the quality control showed values of base + fog as high as 0.24 optical density and speed and contrast outside recommended limits. The radiographic films presented several artifacts that resulted in low quality images. The pilot program consisted of the implementation of the quality control in the mammography service. Several initiatives were taken including training of the technicians, improvement of maintenance of the processors and increase in the number of patients/day from 7 to 12. This procedure allowed replenishment rates to be lowered to acceptable levels. The implementation of the quality control maintained chemical products stable keeping the sensitometric parameters under control. However, the most significant result of the program was better image quality, free from artifacts, a significant reduction in costs to the hospital and especially lower doses imparted to the patients due to the reduction in rejection rates to 7.7%.

Keywords: Quality control, Automatic processors, Sensitometric method

We present the case of a 9-year-old girl with acute suppurative thyroiditis and systemic lupus erythematosus. Early diagnosis was crucial for the outcome of the patient due to the severity of the disease. A review of the literature is also presented.

Keywords: Acute suppurative thyroiditis, Systemic lupus erythematosus, Ultrasonography

The authors report the case of a 51-year-old white female with proven diagnosis of systemic lupus erythematosus and radiological evidence of severe pulmonary fibrosis. The epidemiology of pleuropulmonary manifestations of systemic lupus erythematosus emphasizing pulmonary fibrosis is discussed.

Keywords: Lupus. Systemic lupus erithematosus. Lung. Pulmonary fibrosis.

Systemic lupus erythematosus is an autoimmune disease involving multiple organ systems. Musculoskeletal involvement is one of the most frequent presentations of the disease, affecting bones, joints, muscles, tendons and ligaments, either as a primary manifestation or secondary to the treatment of the disease. In the present article, the authors review and illustrate the joint disorders and the most common musculoskeletal abnormalities seen in this disorder.

Keywords: Systemic lupus erythematosus; Arthropathy; Musculoskeletal abnormalities.

OBJECTIVE: To evaluate mammographic breast density in asymptomatic menopausal women in correlation with clinical and sonographic findings. MATERIALS AND METHODS: Mammograms and clinical and sonographic findings of 238 asymptomatic patients were retrospectively reviewed in the period from February/2022 to June/2006. The following variables were analyzed: mammographic density patterns, sonographic findings, patients' age, parity, body mass index and use of hormone replacement therapy. RESULTS: Age, parity and body mass index showed a negative correlation with breast density pattern, while use of hormone replacement therapy showed a positive correlation. Supplementary breast ultrasonography was performed in 103 (43.2%) patients. Alterations which could not be visualized at mammography were found in 34 (33%) of them, most frequently in women with breast density patterns 3 and 4. CONCLUSION: The authors concluded that breast density patterns were influenced by age, parity, body mass index and time of hormone replacement therapy. Despite not having found any malignant abnormality in the studied cases, the authors have observed a predominance of benign sonographic abnormalities in women with high breast density patterns and without mammographic abnormalities, proving the relevance of supplementary ultrasonography to identify breast lesions in such patients.

Keywords: Mammogram; Breast density; Menopausal; Ultrasonography.

OBJECTIVE: To evaluate the accuracy in the detection of abdominal aortic calcification by densitometry as compared with lateral spine radiography. MATERIALS AND METHODS: Study comprising 80 individuals, 50 of them with abdominal aortic calcification and 30 without calcification. Densitometry was performed once for each participant, with the patient in right lateral decubitus position. RESULTS:Both groups were similar in terms of age range and body mass index - mean age of 74.56 ± 10.55 years and 68.40 ± 10.80 years and mean body mass index of 28.94 ± 6.06 kg/m², and 26.84 ± 4.11 kg/m², respectively for the individuals with abdominal aortic calcification and for the individuals without calcification. A statistical comparison between densitometry and radiography demonstrates similar performances of the two methods in the detection of abdominal aortic calcification, with 100% specificity and positive predictive value, 94% sensitivity, 90.9% negative predictive value, and 96.3% accuracy. Qualitative equivalence in diagnosis was demonstrated by kappa correlation index of 0.922. CONCLUSION: The results obtained by radiography and densitometry were statistically equivalent, which endorses the indication of densitometry for investigating abdominal aortic calcification.

Keywords: Atherosclerosis; Abdominal aorta; Densitometry.