The posterolateral approach for fluoroscopy-guided tibiotalar joint injection.

Objective: To report a novel technique for tibiotalar joint injection that utilizes a posterolateral approach, including indications and technical considerations.

Methods: The posterolateral approach for tibiotalar injection is similar to that used in posterior subtalar joint injections. Using this technique, the tibiotalar joint space is accessed by directing the needle anterosuperiorly beneath the fibula until the posterior aspect of the talar dome has been reached.

Incidentally discovered uterine sarcoma in a premenopausal patient after hysterectomy for postembolization endometritis.

Uterine leiomyomas (fibroids) are the most common benign tumor of the female reproductive system. Fibroids can become symptomatic with symptoms such as menorrhagia and menometrorrhagia, pelvic pain, and reproductive dysfunction. Hysterectomy, myomectomy, and the less invasive uterine artery embolization are now commonly performed if conservative management of symptomatic fibroids fails.

Treatment delay in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction: a key process analysis of patient and program factors.

Background: Most hospitals that perform primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) in the United States exceed the recommended door-to-balloon time. There is heightened interest in identifying and eliminating factors that introduce delay.

Methods: We performed a key process analysis of our primary PCI program, assessed the relative contribution of individual time intervals on total ischemic time, and identified predictors of delay.