A Deep Learning Model for Three-Dimensional Determination of Whole Thoracic Vertebral Bone Mineral Density from Noncontrast Chest CT: The Multi-Ethnic Study of Atherosclerosis.

Background Recent studies have investigated how deep learning (DL) algorithms applied to CT using two-dimensional (2D) segmentation (sagittal or axial planes) can calculate bone mineral density (BMD) and predict osteoporosis-related outcomes. Purpose To determine whether TotalSegmentator, an nnU-net algorithm, can measure three-dimensional (3D) vertebral body BMD across consistently imaged thoracic levels (T1-T10) at any conventional, noncontrast chest CT examination. Materials and Methods This study is a secondary analysis of a multicenter ( = 6) prospective cohort, the Multi-Ethnic Study of Atherosclerosis (MESA).

Sacroiliac dysfunction and minimally invasive sacroiliac joint fusion.

The sacroiliac joint (SIJ) is the largest diarthrodial joint in the human body and accounts for approximately 20% of all low back pain, which is commonly seen in patients with lumbosacral fusions. Despite this, SIJ dysfunction often poses a challenging diagnosis depending on clinical evaluation, imaging, and image-guided joint injection. SIJ fusion is an effective and safe method of treatment, with minimally invasive approaches fitting well within the armamentarium of interventional radiologists treating chronic pain and other musculoskeletal conditions.

Evaluation of Self-Inflicted versus Non-Self-Inflicted Gunshot Wounds and Associated Injuries Involving the Hand and Upper Extremity.

Orthopedic costs associated with gunshot wounds (GSWs) totaled approximately USD 510 million from 2005 to 2014. Previous studies have identified differences in injuries associated with self-inflicted (SI) GSWs; however, there remains a gap in understanding injury patterns. This study aims to expand upon the current literature and shed light on injury patterns and outcomes associated with SI vs.

Conservative Management with Functional Brace Versus Various Surgical Fixation Techniques for Humeral Shaft Fractures: A Network Meta-Analysis.

Background: Historically, humeral shaft fractures have been successfully treated with nonoperative management and functional bracing; however, various surgical options are also available. In the present study, we compared the outcomes of nonoperative versus operative interventions for the treatment of extra-articular humeral shaft fractures.

Methods: This study was a network meta-analysis of prospective randomized controlled trials (RCTs) in which functional bracing was compared with surgical techniques (including open reduction and internal fixation [ORIF], minimally invasive plate osteosynthesis [MIPO], and intramedullary nailing in both antegrade [aIMN] and retrograde [rIMN] directions) for the treatment of humeral shaft fractures.

Meniscus Work and Implant Selection Are Major Cost Drivers of Anterior Cruciate Ligament Reconstruction.

Background The current study examines the financial charges associated with primary anterior cruciate ligament reconstruction (ACLR), specifically the contribution of graft choice, graft type, and concomitant meniscus surgery, in the outpatient hospital setting. Methods A retrospective financial billing review was performed on patients who underwent ACLR at a single academic medical center from January to December 2019. Age, BMI, insurance, length of operation, regional block, implants, meniscus surgery, graft type, and graft choice were extracted from hospital electronic patient records.

Proximal interphalangeal-level fracture in patient with symphalangism.

Symphalangism is a rare, congenital syndrome involving ankylosis of the interphalangeal joints. We present a rare case of fracture at the level of a fused proximal interphalangeal joint in a patient with proximal symphalangism of the hand. Nonoperative management with splinting resulted in osseous healing and restored baseline function.

Symptomatic Bipartite Patella in Adults Treated With Open Excision: Outcomes and Management.

Introduction Bipartite patella affects about 2% of people. Most cases are asymptomatic; however, some develop anterior knee pain during a sporting activity or trauma. When conservative treatment fails, surgery can be considered.

Corrigendum to 'Outcomes of Revision Hip Arthroplasty Using the Supine Anterior- Based Muscle Sparing Approach' [Arthroplasty Today 14 (2022) 199-203].

[This corrects the article DOI: 10.1016/j.artd.

Late presenting developmental dysplasia of the hip after a normal hip ultrasound at 6 weeks of age: A report of two cases.

Developmental hip dysplasia (DDH) is a paediatric condition in which the 'ball and socket' hip joint fails to form properly during infancy. The increased mechanical stress on the hip joint from DDH can contribute to the development of osteoarthritis during adulthood. Therefore, careful physical examination and imaging of all infants to diagnose DDH is critical to provide the best possible functional outcome.

Referral patterns to a pediatric orthopedic clinic: pediatric orthopedic surgeons are primary care musculoskeletal medicine physicians.

In 2004, Reeder and in 2012, Schwend reported that inappropriate nonsurgical referrals to pediatric orthopedic clinics create a misuse of resources. Additional authors have called for re-emphasis and additional training in musculoskeletal medicine for primary care physicians (PCP) to improve the confidence, knowledge and performance when managing musculoskeletal conditions. The current study compares the diagnoses referred to a pediatric orthopedic clinic with diagnoses recommended for referral by the American Academy of Pediatrics (AAP) guidelines to determine if any improvement in the quality of referrals has occurred since Reeder and Schwend's article.

Outcomes of Revision Hip Arthroplasty Using the Supine Anterior-Based Muscle Sparing Approach.

Background: In the United States, the number of revision total hip arthroplasty (THA) cases is projected to grow from 50,000 in 2014 to 85,000 by 2030. The anterior-based muscle sparing approach (ABMS) has been described as a viable approach for primary THA, but little has been written in the revision setting. This study compares the supine ABMS approach to alternative approaches in revision THA.

Outcomes of the Supine Anterior-based Muscle-sparing Approach for Primary and Revision Hip Arthroplasty.

Introduction: Risks and outcomes of total hip arthroplasty (THA) are believed to vary relative to the surgical approach. This study compares the supine anterior-based muscle-sparing (ABMS) approach with its modern-day counterparts.

Methods: A retrospective review was done on 550 patients undergoing primary or revision THA from 2016 to 2018.

The posterior tibial slope and Insall-Salvati index in operative and nonoperative adolescent athletes with Osgood-Schlatter disease.

Introduction: Osgood-Schlatter disease (OSD) is a common cause of anterior knee pain in adolescent athletes due to repetitive stress on the tibial tubercle. The posterior tibial slope angle (PTSA) and the Insall-Salvati Index (ISI) play a role in knee biomechanics. However, to our knowledge, the posterior tibial slope and patellar height have not been compared in operated versus nonoperative OSD patients.

Neurophysiological Intraoperative Monitoring in Patients with Cochlear Implant Undergoing Posterior Spinal Fusion: A Case Report.

Case: Transcranial electric stimulation motor-evoked potentials (tcMEPs) are the most sensitive technique in multimodality intraoperative neuromonitoring (IONM) for posterior spinal fusion (PSF). The presence of a cochlear implant (CI) is considered a contraindication to IONM because of theoretical risk of implant device and local tissue damage from voltages induced by tcMEPs. We present the case of a 10-year-old girl with CI who underwent successful PSF with tcMEP and monopolar electrocautery (MoEC) without perioperative complications or CI damage.

Performance characteristics of urinary cytology in patients presenting with gross and microscopic hematuria.

Purpose: Hematuria investigations presently entail cystoscopy with upper urinary tract imaging albeit without use of urinary biomarkers including cytology. The purpose is to investigate the performance characteristics of urinary cytology in a population of patients presenting with gross (GH) and microscopic (MH) hematuria.

Methods: Records for 409 consecutive patients undergoing a complete hematuria evaluation (cystoscopy with upper-tract imaging) who also had urinary cytology were reviewed.

Open Supracondylar Humerus Fractures in Children.

Purpose: Supracondylar humerus (SCH) fractures are the most common elbow fracture in children; however, they rarely occur as open injuries. Open fractures are associated with higher rates of infection, neurovascular injury, compartment syndrome, and nonunion. The purpose of this study was to evaluate the treatment and outcomes of open SCH fractures in children.

Outcomes of surgical treatment of symptomatic bipartite patella in teenage athletes.

Bipartite patella affects about 2% of people. Most cases are asymptomatic; however, some develop anterior knee pain during sports. When conservative treatment fails, surgery can be considered.

Lyme Disease Misinterpreted as Child Abuse.

Child abuse is one of the most common causes for child fatality in the United States. Inaccurate reporting of child abuse combined with scarcity of resources for child abuse evaluations can lead to unintended consequences for children and their families. The differential diagnosis of child abuse is varied.

Modern Day Scurvy in Pediatric Orthopaedics: A Forgotten Illness.

Introduction: Scurvy, or vitamin C deficiency, is rare. The goal of this study is to highlight the common risk factors and identify the orthopaedic presentation of scurvy in children.

Methods: A retrospective chart and radiograph review was performed of all patients consulted to the pediatric orthopaedic service from 2010 to 2019 who ultimately had the diagnosis of scurvy confirmed by an abnormally low serum vitamin C level.

Dual inhibition of glycolysis and glutaminolysis as a therapeutic strategy in the treatment of ovarian cancer.

Cancer cell metabolism is required to support the biosynthetic demands of cell growth and cell division, and to maintain reduction oxidaton (redox) homeostasis. This study was designed to test the effects of glucose and glutamine on ovarian cancer cell growth and explore the inter-relationship between glycolysis and glutaminolysis. The SKOV3, IGROV-1 and Hey ovarian cancer cell lines were assayed for glucose, pyruvate and glutamine dependence by analyzing cytotoxicity, cell cycle progression, apoptosis and ATP production.