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    Bipartitism in tarsal bones: A retrospective analysis of clinical and radiological features
    (2024) Maras Ozdemir, Zeynep; Karakaplan, Mustafa; Ergen, Emre; Köroğlu, Muhammed; Aslantürk, Okan; Özdeş, Hüseyin Utku; Çoban, İdris
    Aim: Bipartitism in the foot, especially in the tarsal bones, is a rare anatomical variant characterized by dividing one bone into two separate ossification centers. This condition can be congenital or acquired, often remains asymptomatic, and is only discovered incidentally during radiological imaging. This study aims to present a comprehensive retrospective analysis of bipartitism in tarsal bones, assessing its prevalence, type of articulation, and associated clinical features in a cohort of patients. Materials and Methods: A total of 4,645 patients were retrospectively evaluated from 6,145-foot images consisting of 4,975 computed tomography (CT) and 1,170 magnetic resonance imaging (MRI) scans obtained between 2015 and 2023. 15 patients with tarsal bipartitism were identified and contacted through the hospital system for in-person medical history and examination. Radiological exams assessed partial and complete bipartition, diastasis, and exostosis in the tarsal bones. Age, sex, side, trauma history, pain, foot deformity, gait disturbance, and other clinical findings were also recorded. Results: Bipartitism was detected in 15 patients (0.32%), predominantly affecting males (87%). The most common variant was medial cuneiform bipartitism, observed in 13 patients (0.28%). Talus and calcaneus bipartitism were each observed in one patient (0.02%). Bilateral involvement was present in 67% of the cases, with 60% of patients reporting chronic pain. Complete dissociation of bipartite bones was noted in 80% of cases. Accompanying bipartitism, two patients had pes planovalgus, and one had hallux varus deformity. Conclusion: Although bipartitism of the tarsal bones is rare, it remains a diagnostic challenge due to variability in clinical presentation and possible association with other foot deformities. Accurate diagnosis through advanced imaging techniques is essential to differentiate these variants from fractures and guide appropriate treatment. This study contributes valuable insights into the prevalence and clinical impact of bipartitism in the tarsal bones, emphasizing the importance of early diagnosis and individualized treatment strategies.
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    Diyabetik Ayak ve Osteomiyelit
    (2023) Maras Ozdemir, Zeynep
    Diyabetik ayak enfeksiyonlarında erken ve doğru tanı koymak olası morbidite ve mortalite risklerini azalt- mak için çok önemlidir. Manyetik rezonans görüntülemesi (MRG), kemik ve yumuşak dokudaki enfeksiyonu saptamada ve yaygınlığını göstermede en kullanışlı görüntüleme yöntemidir. MRG’de bir ülser veya sinüs traktı komşuluğunda görülen kemik iliği sinyal anormallikleri bizi osteomiyelit tanısına götürebilir. Ancak diyabetik ayakta karşımıza çıkabilecek nöropatik osteoartropati ve üstüne eklenen enfeksiyon varlığı kafa karışıklığına yol açabilir. Bu yazının amacı, diyabetik ayakta osteomiyelit tanısı, nöropatik osteoartropa- tiden ayrımı ve nöropatik osteoartropatinin üstüne eklenmiş osteomiyelitin değerlendirilmesinde daha fazla yorum yapmamızı sağlamaktır.
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    The Effect of Clinical Knowledge on the Evaluation of Sacroiliac Joint Radiography in Patients with Spondyloarthritis
    (Mdpi, 2025) Zontul, Sezgin; Kaya, Zeynep; Aydogdu, Mesude Seda; Arslan, Ahmet Kadir; Inanc, Elif; Maras Ozdemir, Zeynep; Yolbas, Servet
    Background/Objectives: This study investigates whether a patient's clinical status influences the evaluation of sacroiliac joint (SIJ) radiographs. Methods: The study involved analysing SIJ radiographs of patients diagnosed with spondyloarthritis (SpA) at our clinic. Two rheumatologists working at another centre evaluated the images independently. Three months were allowed to elapse so that the rheumatologists would forget the results of the first evaluation. The radiographs were then re-evaluated in a different order by the same rheumatologists. However, during the second evaluation, the evaluators were also provided with general clinical information about the patients. Inter- and intra-observer agreement were assessed. Results: In the first blinded evaluation of our study, we found moderate-to-substantial agreement between rheumatologists (right kappa: 0.534; p < 0.001; left kappa: 0.609; p < 0.001) and statistically significant interpretation agreement. In the second evaluation, we observed an increase in agreement (kappa increased from 0.534 to 0.774 for the right SIJ and from 0.609 to 0.855 for the left SIJ), and these metrics were also significant. Conclusions: The interpretation of SIJ radiographs showed notable inter-observer variability in the absence of clinical information. Incorporating clinical context significantly improved the agreement between readers. As conventional radiography remains central to spondyloarthritis classification, these findings highlight the value of clinical data in enhancing the reliability of radiographic assessment. To our knowledge, this is the first study to systematically demonstrate the impact of clinical information on inter-observer agreement in SIJ radiograph interpretation.