Screening for colorectal neoplasia with CT colonography: initial experience from the 1st year of coverage by third-party payers.

Purpose: To evaluate our experience in the 1st year of computed tomographic (CT) colonography screening since the initiation of local third-party payer coverage.

Materials And Methods: This HIPAA-compliant study was approved by the institutional review board, and informed consent was waived. Over a 1-year period that ended on April 27, 2005, 1110 consecutive adults (585 women, 525 men; mean age, 58.

Osteoporotic compression fractures of the spine; current options and considerations for treatment.

Background Context: Vertebral compression fractures affect at least one-fourth of all postmenopausal women. The most significant risk factor is osteoporosis, most commonly seen among Caucasian women a decade or so after menopause. Osteoporosis typically results from inadequate accumulation of bone mass during childhood and early adulthood followed by rapid resorption after menopause.

A review of the 2001 Volvo Award winner in clinical studies: lumbar fusion versus nonsurgical treatment for chronic low back pain: a multicenter randomized controlled trial from the Swedish lumbar spine study group.

The current debate over the efficacy of lumbar fusion for low back pain has not been settled. Fritzell et al published a landmark paper entitled "Lumbar fusion versus nonsurgical treatment for chronic low back pain: a multicenter randomized controlled trial from the Swedish lumbar spine study group." Their goal was to provide objective evidence supporting lumbar fusion.

Arthroscopic treatment of posterolateral elbow impingement from lateral synovial plicae in throwing athletes and golfers.

Background: Although elbow pain is common in throwing athletes and golfers, posterolateral impingement from a hypertrophic synovial plica is a rare but possibly underdiagnosed condition.

Purpose: To evaluate the clinical results of arthroscopic treatment of symptomatic lateral elbow plicae in this athletic population.

Study Design: Case series; Level of evidence, 4.

Process and tubercle fractures of the hindfoot.

Process and tubercle fractures of the talus and calcaneus can be a source of significant pain and dysfunction. Successful management requires extensive knowledge of the complex osseoligamentous anatomy of the hindfoot. The large posterior process of the talus is composed of a medial and a lateral tubercle; an os trigonum may exist posterior to the lateral tubercle.

Biomechanical comparison of a single-row versus double-row suture anchor technique for rotator cuff repair.

Background: Reestablishment of the native footprint during rotator cuff repair has been suggested as an important criterion for optimizing healing potential and fixation strength.

Hypothesis: A double-row rotator cuff footprint repair will demonstrate superior biomechanical properties compared with a single-row repair.

Study Design: Controlled laboratory study.

Rheumatoid arthritis in the cervical spine.

The cervical spine often becomes involved early in the course of rheumatoid arthritis, leading to three different patterns of instability: atlantoaxial subluxation, atlantoaxial impaction, and subaxial subluxation. Although radiographic changes are common, the prevalence of neurologic injury is relatively low. The primary goal of treatment is to prevent permanent neurologic injury while avoiding potentially dangerous and unnecessary surgery.

Timing of surgical stabilization after cervical and thoracic trauma. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004.

Appropriate timing for surgical intervention following destabilizing cervical or thoracic spine trauma remains controversial. Clinical investigators have failed to provide convincing evidence that the timing of surgery significantly affects neurological outcome in most situations. Nevertheless, early surgical stabilization of the injured spine has been shown to provide significant nonneurological benefits such as more rapid patient mobilization, facilitation of treating associated injuries, reduction in rates of pulmonary and pressure sore complications, reduction in duration of intensive care unit and hospital stays, and a decrease in overall medical costs.

Outcomes following anterior cervical discectomy and fusion: the role of interbody disc height, angulation, and spinous process distance.

Objective: Anterior cervical discectomy and fusion (ACDF) is a successful procedure for the degenerative cervical spine. One goal of the fusion is to restore the loss of disc height that results from the degenerative process. Whereas cervical alignment improves with increased disc height, the ideal graft size used for disc space restoration is unknown.

Shoulder injuries in golf.

Although often perceived as a leisurely activity, golf can be a demanding sport, which can result in injury, usually from overuse and sometimes from poor technique. The shoulder is a commonly affected site, with the lead shoulder, or the left shoulder in the right-handed golfer, particularly vulnerable to injury. A thorough understanding of the biomechanics of the golf swing is helpful in diagnosing and managing these injuries.

Arthroscopic treatment of the arthrofibrotic knee.

The management of motion loss of the knee is challenging. A clear understanding of the pathoanatomic causes of motion loss is necessary to establish a careful and rational approach to treatment. Early recognition and physical therapy are effective for the majority of patients, but when these conservative measures fail, operative intervention is indicated.

Calcifying tendinitis of the rotator cuff with cortical bone erosion.

Calcifying tendinitis occurs most commonly in the rotator cuff tendons, particularly involving the supraspinatus tendon insertion, and is often asymptomatic. Cortical erosion secondary to calcifying tendinitis has been reported in multiple locations, including in the rotator cuff tendons. We present a pathologically proven case of symptomatic calcifying tendinitis involving the infraspinatus tendon with cortical erosion with correlative radiographic, CT, and MR findings.

Fibular position in relation to lateral ankle instability.

Background: The position of the fibula within the ankle mortise may be a factor contributing to recurrent ankle instability. The current study was performed to determine whether significant differences in fibular position exist in a population of patients who underwent lateral ankle stabilization procedures. The hypothesis that a fibula positioned posteriorly within the mortise predisposes the ankle to chronic instability was evaluated.

Diagnosis and management of sacral spine fractures.

The sacrum is the mechanical hub of the axial skeleton, serving as the base for the spinal column and keystone for the pelvic ring. Both surgical and nonsurgical options are available to treat sacral spine fractures; however, because these fractures are relatively rare and heterogeneous in nature and because there is little evidence-based literature, choosing the optimal treatment is challenging. The timing of intervention and the choice of surgical technique need to be determined on an individual basis, with the goal of producing the best outcome for the patient.

Diagnosis and management of thoracolumbar spine fractures.

The lack of robust clinical studies has contributed to controversy regarding optimal treatment for patients with injuries to the thoracolumbar spine. The transitional anatomy of the thoracolumbar spine makes it vulnerable to injury resulting from high-energy motor vehicle collisions and falls; osteoporosis is an underlying factor in most of the compression fractures identified in elderly patients. The formulation of a treatment plan for patients with injuries to the thoracolumbar spine depends on the presence and extent of neurologic injury and deformity and an estimate concerning spinal stability.

Prognostic significance of cyclooxygenase-2 in oropharyngeal squamous cell carcinoma.

Purpose: To determine the relative prognostic significance of cyclooxygenase (COX)-2 expression in patients with oropharyngeal squamous cell carcinoma (SCC).

Experimental Design: This retrospective cohort study included 82 patients with SCC referred to the Department of Therapeutic Radiology at Yale-New Haven Hospital (Connecticut) between 1980 and 1999 who were treated with primary external beam radiotherapy or gross total surgical resection and postoperative radiotherapy. A microarray of archival tumor tissue was constructed and stained with monoclonal antibodies directed against COX-2 and scored for intensity by a pathologist blinded to the clinical outcomes of the patients.