Advanced Interventional Procedures for Knee Osteoarthritis: What Is the Current Evidence?

The prevalence of knee osteoarthritis (OA) is the highest among all joints and likely to increase over the coming decades. Advances in the repertoire of diagnostic capabilities of imaging and an expansion in the availability and range of image-guided interventions has led to development of more advanced interventional procedures targeting pain related to OA pain while improving the function of patients presenting with this debilitating condition. We review the spectrum of established advanced interventional procedures for knee OA, describe the techniques used to perform these procedures safely, and discuss the clinical evidence supporting each of them.

The Beauty of Musculoskeletal Ultrasound: Spot Diagnoses.

INTRODUCTION: Ultrasound is a powerful technique in musculoskeletal (MSK) imaging, and it can replace MR imaging in many specific clinical scenarios. This article will feature some common and less common spot diagnoses in musculoskeletal ultrasound. SPOT DIAGNOSIS: Cases were collected by members of the Educational Committee of the ESSR ( European Society of Musculoskeletal Radiology) with expertise in musculoskeletal ultrasound. Sixteen clinical entities are discussed based on the features that allow US spot diagnosis. CONCLUSION: Clinical history, location, and ultrasound appearance are the keys to spot diagnoses when performing musculoskeletal ultrasound. KEY POINTS: · Musculoskeletal ultrasound can be the primary and only modality in common spot diagnoses in specific clinical settings.. · Clinical history, location, and ultrasound appearance are keys to spot diagnoses.. · Knowledge of spot diagnoses in musculoskeletal ultrasound facilitates daily clinical practice.. CITATION FORMAT: · Drakonaki EE, Martinoli C, Vanhoenacker FM et al. The Beauty of Musculoskeletal Ultrasound: Spot Diagnoses. Fortschr Röntgenstr 2023; 195: 385 - 392.

The impact of digitisation of a virtual fracture clinic on referral quality, outcomes and assessment times.

BACKGROUND: Virtual fracture clinics (VFCs) have become widely adopted, aiming to improve efficiency, standardise patient care and reduce clinic appointments for injuries that can be managed conservatively. A variety of means exist to manage VFC referrals and assessment, including paper-based and digital methods. This study assesses VFC referral quality and outcomes before and after implementation of a digital VFC referral and management system. METHODS: A retrospective analysis was conducted of all VFC referrals and assessments from July 2017-March 2020 in a large UK district general hospital. All referrals and assessments were analysed for quality and completeness of referral information, grade of assessor, outcome of assessment, referral-to-assessment time, and assessment-to-surgery time (for those requiring operative management). RESULTS: 3038 paper and 9,228 digital referrals were analysed by 2 separate reviewers. Quality and completeness of referral information showed significant improvement in 11 predetermined key data points with the digital referral system (p < 0.001). Date and mechanism of injury were the most commonly missing data criteria (67.5% and 68.2%, respectively) with paper referrals. Significant improvements were noted in the proportion of Consultant delivered VFC assessments (84.2% vs 71.0%; p < 0.001), VFC discharge rate (20.8% vs 13.1%; p < 0.001) and patients recalled for urgent review (6.2% vs 0.8%; p < 0.001) with digital referrals. Mean referral-to-assessment (31.2 vs 49.9 h; p < 0.001) and assessment-to-surgery (9.2 vs 13.0 days; p = 0.01) times also reduced significantly with referral digitisation. CONCLUSION: Improvements in virtual referral quality and completeness directly lead to facilitation of more thorough, detailed and appropriate virtual assessments; improving timely decision-making, reducing unnecessary appointments, and permitting better prioritisation of workload and earlier surgery for patients requiring operative treatment. Purpose-built digital solutions are an excellent means of achieving these aims.

The role of body composition assessment in obesity and eating disorders.

Lack of a balanced diet can have a significant impact on most organs of the body. Traditionally, evaluation of these conditions relied heavily upon body mass index "BMI" measurements, which are limited and open to inaccurate interpretation or omission of critical data. Advances in imaging allow better recognition of these conditions using accurate qualitative and quantitative data and correlation with any morphological changes in organs. Body composition evaluations include the assessment of the bone mineral density (BMD), visceral fat, subcutaneous fat, liver fat and iron overload and muscle fat (including the lean muscle ratio), with differential evaluation of specific muscle groups when required. Such measurements are important as a baseline and for monitoring the effect of therapies and various interventions. In addition, they may predict and help alleviate any potential complications, allowing counselling of patients in a relatable manner. This positively influences patient compliance and outcomes during early counselling, monitoring and modulation of therapy. This encourages patients suffering from obesity and eating disorders to better understand their often chronic but reversible condition. We present a review of current literature with reflection on our own practices. We discuss the importance of monitoring the reversibility of certain parameters in specific cohorts of patients. We consider the role of artificial intelligence and deep learning in developing software algorithms that can help the reading radiologist evaluate large volumes of data and present the results in a format that is easier to interpret, thereby reducing interobserver and intraobserver variabilities.