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Potsi App

POSTERIOR TRUNK SYMMETRY INDEX 

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balance, parameters, measure, angle, dislocation radiographic, sacral, slope, app, angle,PI,SS,Tilt, PT, saggital, orthopaedic, vertebral, body, fusion, deformity, AnteInclination, AI, Sacroacetabular angle,SAA, femoral,PFA, coronal, alignment,Neutral, Negative, Positive, stable, classification, lordosis, kyphosis, x-rays, compensation, scoliosis, imbalance,Thoracic,Thoracolumbar, Curves, Cobb, plate, Idiopathic, Adolescent, juvenile, method, end,Trunk, Shift, Obliquity, Discrepancy, Translation , apex,Rotation, Pedicle, edge, symmetric, subluxation, Lateral, Grade, horizontal, i-tune

By visual inspection of the spine, asymmetry of the back is significant enough to suspect the existence of scoliosis in such cases, to evaluate spinal deformity an X-ray is ordered. Scoliometers could help evaluate the appearance of an asymmetric spine deformity with variable sensitivity and specificity but cannot substitute radiography. It is widely reported in the literature that significant correlations between radiographs and topographic parameters were found. Posterior Trunk Symmetry Index (POTSI)  is a useful Index in the assessment of spinal deformity. POTSI Index is very sensitive in revealing any frontal plane asymmetry and could help identify moderate deformities which might otherwise be missed in clinics or physical examination. The Potsi Index is the sum two variables Height Asymmetry Index (HAI) and Frontal Asymmetry Index (FAI). Height asymmetry indexes are obtained as the sum of height differences of the shoulders, axillary folds, and waist creases, and it is normalized with the division of its value by the vertical distance from the C7 vertebra to the baseline of the gluteal cleft. The Potsi App calculates the Potsi Index according to the above mentioned developed topographic method (Suzuki N, Inami ) and offers a way to evaluate external back deformities with noninvasive technique. It is inexpensive and can be repeated indefinite times thus reducing unnecessary x-rays for normal anatomies and mild case. The app helps the doctor in an outpatient setting to measure all the indexes in a blink of the eye by clicking few points.The app is medical software aimed for orthopaedic surgeons, providing tools that allow doctors to:
-Securely import medical images directly from the camera or stored photos.
-by marking certain multiple anatomical points over the patients back the app can evaluate  back’s symmetry in a few seconds. Eight specific points at the surface of the patient’s back are required. POTSI is relatively simple to measure, even on regular photography of the back. Ideal POTSI is zero, meaning full symmetry of the back surface. The App calculates all necessary elaborate formulas and after analysis the posterior trunk symmetry index(POTSI) is printed (normal value <10). 
-Save the planned images, for later review or consultation.        
    In a busy everyday practice, measuring all these parameters needed to calculate the Index by the classic way is time consuming and cumbersome. Additional expensive equipment is not needed. Back surface topography by means of structured light in the screening is not needed to mark the necessary points for calculating the Potsi Index. Simple back images taken by phone camera are sufficient. The app offers a very convenient and  accurate way to perform measurements.The app could help to monitor objectively the course  and evaluate optimally spine deformities. This App is particularly useful especially in clinical settings where you need a quick results without losing time. For specialist a useful tool to monitor  quantitatively the cosmetic defect during clinical sessions and to objectively evaluate the effects of surgery on trunk shape. 
The progression of scoliosis is routinely monitored using radiography as frequently as every three months. Unpredictable worsen requires surgical intervention to prevent further deterioration. The app might help to reduce patient exposure preventing also unnecessary x-rays for normal anatomies or mild cases.The Posterior Trunk  Symmetry Index (POTSI) is sensitive to identify slight asymmetries especially in normal children. By the advent of  the App the required time and cost effectiveness of the examinations necessary to diagnosed and follow-up patients with scoliosis could be reduced. The App provides a useful tool  which helps to quantify the spine deformity and help to establish diagnosis . 
    All information received from the software output must be clinically reviewed regarding its plausibility before patient treatment! The App is indicated for assisting healthcare professionals. Clinical judgment and experience are required to properly use the software. The software is not for primary image interpretation. 
Reference

1.Pino-Almero L1, Mínguez-Rey MF, Rodríguez-Martínez D, Cibrián-Ortiz de Anda RM, Salvador-Palmer MR, Sentamans-Segarra S. Clinical application of back surface topography by means of structured light in the screening of idiopathic scoliosis. J Pediatr Orthop B. 2017 Jan;26(1):64-72.
2.Mínguez MF1, Buendía M, et all Quantifier variables of the back surface deformity obtained with a noninvasive structured light method: evaluation of their usefulness in idiopathic scoliosis diagnosis.Eur Spine J. 2007 Jan;16(1):73-82. Epub 2006 Apr 12.
3.Suzuki N, Inami K, Ono T, Kohno K, Asher MA. Analysis of posterior trunk symmetry index(POTSI) in scoliosis, part 1. Stud Health

balance, parameters, measure, angle, dislocation radiographic, sacral, slope, app, angle,PI,SS,Tilt, PT, saggital, orthopaedic, vertebral, body, fusion, deformity, AnteInclination, AI, Sacroacetabular angle,SAA, femoral,PFA, coronal, alignment,Neutral, Negative, Positive, stable, classification, lordosis, kyphosis, x-rays, compensation, scoliosis, imbalance,Thoracic,Thoracolumbar, Curves, Cobb, plate, Idiopathic, Adolescent, juvenile, method, end,Trunk, Shift, Obliquity, Discrepancy, Translation , apex,Rotation, Pedicle, edge, symmetric, subluxation, Lateral, Grade, horizontal, i-tune

HOW TO MEASURE POTSI INDEX WITH THE POTSI APP.

The following anatomical landmarks on the image of patient’s back should be selected and marked sequentially by the transparent template in clockwise direction starting from the C7 (P1) and afterwards from one side to the other side - clockwise-, namely spinal process of C7 vertebra first (P1), next one side shoulder corner (P2), next same side axillary fold (P3), same side waist creases (P4), gluteal cleft (P5), other side’s waist creases (P6), other side’s  axillary fold (P7), and finally other side’s shoulder corner (P8). Powerful undo feature is available. By pressing the ‘undo’  button incase of wrong point selection the measurement return to last point marked. 
 

All information received from the software output must be clinically reviewed regarding its plausibility before patient treatment! The App is indicated for assisting healthcare professionals. Clinical judgment and experience are required to properly use the software. The software is not for primary image interpretation. 
In quick view, the following reference points should be marked  sequentially beginning from one side left or right - according to examiner preference - clock wise and marking the anatomical points by the following order:
P1 → spinal process of C7 vertebra
P2 → one side shoulder corner 
P3 → one side axillary fold 
P4 → one side waist creases
P5 → gluteal cleft
P6 → other side waist creases
P7 → other side  axillary fold
P8 → other side shoulder corner
Potsi Index - POsterior Trunk Symmetry Index
HAI - Height Asymmetry Index 
FAI- Frontal Asymmetry Index
Potsi Index <=10 Normal
Potsi  Index >10 pathologic 

balance, parameters, measure, angle, dislocation radiographic, sacral, slope, app, angle,PI,SS,Tilt, PT, saggital, orthopaedic, vertebral, body, fusion, deformity, AnteInclination, AI, Sacroacetabular angle,SAA, femoral,PFA, coronal, alignment,Neutral, Negative, Positive, stable, classification, lordosis, kyphosis, x-rays, compensation, scoliosis, imbalance,Thoracic,Thoracolumbar, Curves, Cobb, plate, Idiopathic, Adolescent, juvenile, method, end,Trunk, Shift, Obliquity, Discrepancy, Translation , apex,Rotation, Pedicle, edge, symmetric, subluxation, Lateral, Grade, horizontal, i-tune