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PURPOSE: To create tridimensional (3D) anatomical models of diaphyseal fractures in dogs (3D AMDFD) and to evaluate the models from their radiographs. METHODS: The study consisted of six stages: preparation of femur from a healthy dog cadaver; digitalization of the bone through a 3D scanner and creation of the base model; creation of a 3D AMDFD based on the image of the base model, 3D modeling carried out to reproduce five different types of diaphyseal fractures; printing the models produced on a 3D printer with a thermoplastic material; insertion of neodymium magnets in the fracture line to allow the assembly and disassembly of the parts; and radiography of 3D AMDFD in lateromedial and craniocaudal positions. RESULTS: The base model and 3D AMDFD had high precision in the replication of bone structures, like the bone in natura. The radiopacity and radiolucency of the 3D AMDFD did not necessarily correspond to the bone densities found in the radiography of the natural canine femur. CONCLUSION: The 3D AMDFD and their respective radiographs accurately reproduced the anatomical structures and fracture lines.

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INTRODUCTION: Knee osteoarthritis is one of the most prevalent and debilitating musculoskeletal diseases, with a high incidence among the elderly population. Early detection and accurate classification can improve clinical outcomes for affected patients. OBJECTIVE: This study investigates the use of artificial intelligence (AI) and computer vision for automated detection and classification of knee osteoarthritis using the IKDC classification system. The aim was to develop an automated system for this purpose and evaluate its accuracy in classifying disease severity. MATERIALS AND METHODS: A public dataset containing radiographic knee images with varying degrees of osteoarthritis, previously classified according to the IKDC scale, was utilized. Images were processed using LandingLens software, an advanced computer vision platform facilitating AI model development and implementation. A machine learning model based on the ConvNext architecture-a convolutional neural network-was trained on 1901 images and evaluated using 380 test images. RESULTS: The model demonstrated an overall accuracy of 95.16% in classifying knee osteoarthritis according to the IKDC scale, with a sensitivity of 95.11%. Class-specific accuracies were 92.40% for class A, 93.20% for class B, 98.45% for class C, and 95.69% for class D. These results highlight the model's capability to distinguish between different severity grades of osteoarthritis with high accuracy. CONCLUSION: This study underscores the efficacy of AI and computer vision in automating knee osteoarthritis detection, providing a precise and reliable tool for physicians in disease diagnosis. Integrating these technologies into clinical practice has the potential to enhance efficiency and consistency in patient evaluation, potentially leading to improved clinical outcomes and more personalized medical care. LEVEL OF EVIDENCE: Level III.

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OBJECTIVE: Röntgen's discovery made international news in January 1896, but the appearance of x-rays in Puerto Rico has been dated to 1911. This investigation was undertaken to identify the time, place, participants, and equipment of the first public demonstration of x-rays in Puerto Rico, document other users before 1911, and frame the events and persons in their social, professional, and international contexts. METHODS: Information was retrieved from digitized Puerto Rico newspapers available online and secondary printed and digital sources. DISCUSSION: The first demonstration of x rays in Puerto Rico was organized by physician José Esteban Saldaña in June 1897 and included Francisco Pelati (who documented the event), an electrician; José C. Barbosa, Francisco and Pedro Del Valle, and Juan and Ricardo Hernández, physicians; and José A. Canals, an engineer. Other users prior to 1911 are documented. CONCLUSIONS: Internationally, the first reaction to the discovery of x-rays was a mixture of wonder, experimentation, fascination with a scientific novelty carrying other-worldly resonance, and recognition of potential dangers. Puerto Rico was not an exception. The news arrived in seven weeks, although the equipment (apparently from New York) arrived a year and a half later (June 1897). The readily apparent common denominator for this group of first users is political affiliation, but they were connected by a variety of experiences, despite differences in race, class, and religious ideas. As in other places, x-ray use increased slowly and was available in several cities in Puerto Rico by 1911.

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BACKGROUND: Tillaux-Chaput fractures (TCFs) consist of fractures of the anterolateral distal tibia. They rarely occur in isolation in adults. When TCFs are missed, there is a risk of chronic pain, instability, and ankle osteoarthritis. This study aimed to identify which factors are related to the presence of TCFs in ankle injuries. METHODS: A retrospective review of 1134 ankle fractures evaluated between 2013 and 2023 at a level 1 trauma center was performed. Inclusion criteria were patients aged ≥18 years, ankle radiographs and computed tomographic (CT) scan evaluation, and the presence of a TCF confirmed by CT scan. Exclusion criteria were prior ankle surgery, pilon, or distal tibial fractures. A musculoskeletal radiologist and a foot and ankle-trained orthopaedic surgeon classified the TCFs into type 1, an extraarticular avulsion; type 2, a fracture involving the incisura fibularis; and type 3, a fracture with impaction of the anterolateral tibial plafond. A matching control group of ankle fractures without TCF was created with a 1:2 ratio. The following variables were collected: sex, age (<50 vs >50 years), ankle dislocation or subluxation, Weber classification, Maisonneuve fracture, type of medial and posterior malleolar fracture, Lauge-Hansen classification, malleoli involved, and osteochondral lesion of the talus. Multivariate logistic regression was performed to detect which variables had an association with the TCF and their subtypes. P value <.05 was considered significant. RESULTS: A total of 481 ankle fractures had radiographs and CT scans available for evaluation, of which 83 (17.3%) had a TCF. Of these, 44.6% were type 1, 44.6% type 2, and 9.6% type 3. The mean age was 52.2 years; 66.3% were women. Six patients (7.2%) had an isolated TCF. Fifty-eight (69.9%), 50 (60.2%), and 62 (74.7%) ankles had involvement of the lateral, medial, and posterior malleolus, respectively. Age ≥50 years (OR 2.73, 95% CI 1.45-5.14) and pronation external rotation injuries (OR 2.94, 95% CI 1.43-6.06) had a significant association with TCF. Moreover, ankle dislocation or subluxation (OR 3.16, 95% CI 1.11-8.96) and the absence of posterior malleolar fracture (OR 5.97, 95% CI 1.65-21.6) were significantly associated with TCF type 2 and 3. CONCLUSION: In this study, age ≥50 years and pronation external rotation injuries were the unique independent risk factors for TCF. Furthermore, ankle dislocation or subluxation and the absence of posterior malleolar fractures increased the odds of having a more severe TCF. This study provides insights into the factors associated with TCF and its subtypes during adulthood.

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OBJECTIVE: The aim of our study was to evaluate the effect of anatomical measurements consisting of volar tilt, radial length, radial inclination, and ulnar variance obtained from X-ray radiography in predicting deformity in patients with rheumatoid arthritis and the power of these measurements in predicting rheumatoid arthritis in patients with nonspecific wrist pain. METHODS: A total of 98 rheumatoid arthritis and 40 control patients presenting with nonspecific wrist pain were cross-sectionally evaluated by X-ray radiography. Rheumatoid arthritis patients were divided into subgroups with and without deformity. Volar tilt, radial length, radial inclination, and ulnar variance measurements were performed. RESULTS: When the anatomical measurements of rheumatoid arthritis patients with and without wrist deformity were compared with the control group, volar tilt and radial length were significantly lower in rheumatoid arthritis patients with and without wrist deformity than in the control group. There was no difference between rheumatoid arthritis groups with and without deformity. CONCLUSIONS: Low volar tilt and radial length may be an early X-ray radiographic finding of rheumatoid arthritis and may provide additional diagnostic data in patients presenting with nonspecific wrist pain, especially for seronegative rheumatoid arthritis where diagnosis is difficult.

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Background and Objectives: Patellofemoral pain (PFP) is frequent in the young and active population. The effect of muscle strength in the lower extremities after aerobic activity in patients with this condition has yet to be detailed. Our objective was to determine if patients with PFP show alterations in lower extremity muscle strength measurements after performing a session of ten minutes of aerobic activity on a treadmill compared to people without patellofemoral pain. Materials and Methods: We conducted a prospective experimental study with a stratified, non-randomized, and non-blinded population sample with group matching, including an experimental group with PFP and a control group with no pain. Subjects completed self-reported functional questionnaires (IKDC, Kujala, KOOS, SF-12), underwent radiographic studies, and were evaluated by measuring the strength of hip and knee muscles and the Single-Leg Triple-Hop (SLTH) test before and after ten minutes of exercise on a treadmill. Results: Seventeen subjects diagnosed with PFP and seventeen control subjects were evaluated. Both groups were homogeneous and had no significant differences in the demographic variables. A wider sulcus angle at 30° (136.8 ± 3.8° vs. 132.5 ± 5.6°, p = 0.0140), a decrease strength post-exercise in the hip abductor (37.9 ± 7.1 N⋅m vs. 45.6 ± 7.7 N⋅m, p < 0.05) and knee extensor (36.0 ± 9.1 N⋅m vs. 47.7 ± 14.0 N⋅m, p < 0.05), and a shorter distance in the SLTH test (337.9 ± 74.9 cm vs. 438.6 ± 65.8 cm, p < 0.01) was recorded in subjects with patellofemoral pain. Conclusions: Subjects with PFP had an overall lower strength of hip and knee muscles, showing significant differences in the hip abductors and knee extensors between people with PFP and healthy matched controls after aerobic exercise.

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INTRODUCTION: lumbar foraminal stenosis refers to the constriction of the lateral canal through which the nerve root exits the spinal canal in the lumbar spine. It occurs in 8-11% of patients aged over 40 years. Failure to detect and alleviate foraminal constriction can contribute to up to 60% of instances of unsuccessful lumbar surgery. This study aimed to develop an index to assess the extent of foraminal narrowing, thereby aiding decisions regarding direct or indirect foraminal decompression. MATERIAL AND METHODS: a cross-sectional study was conducted, involving 49 patients, wherein measurements of all five lumbar foramina were taken using X-rays and simple magnetic resonance imaging. These measurements primarily focused on the foraminal width and the lower endplate, which were then correlated to establish a foraminal width/lower endplate index. RESULTS: the foraminal width/lower endplate index < 10% yielded an odds ratio (OR) of 3.07 on lateral radiography, 3.59 on flexion radiography, and 4.01 on extension radiography. In MRI, an OR of 0.195 was found for the left foramina, while an OR of 3.07 was observed for the right foramina. CONCLUSION: this study paves the way for further exploration of preoperative and postoperative clinical outcomes across various surgical decompression methods guided by the FW/LE index. To enhance decision making, it is recommended to conduct research comparing pre- and postoperative clinical findings in individual patients, considering their FW/LE index measurements.

INTRODUCCIÓN: la estenosis foraminal lumbar se define como el estrechamiento del canal lateral por donde sale la raíz nerviosa del canal espinal en la columna lumbar, ocurre de 8-11% en pacientes mayores de 40 años. El fallo en la detección y descompresión del foramen representa 60% de las causas de cirugía lumbar fallida. Este estudio tuvo como objetivo generar un índice que evalúa el grado de estrechez foraminal y así apoyar la toma de decisiones para una descompresión foraminal directa o indirecta. MATERIAL Y MÉTODOS: se realizó un estudio transversal, donde se incluyeron 49 pacientes a los cuales se les midieron los cinco forámenes lumbares con rayos X y resonancia magnética simple. Estas mediciones incluyeron principalmente el ancho foraminal y la plataforma vertebral inferior del cuerpo vertebral superior y se correlacionaron para formar un índice ancho foraminal/plataforma vertebral inferior. RESULTADOS: el índice ancho foraminal/plataforma vertebral inferior < 10% tiene un OR de 3.07 en la radiografía lateral, un OR de 3.59 en la radiografía en flexión y un OR de 4.01 en la radiografía en extensión. En la resonancia magnética se obtuvo un OR de 0.195 para los forámenes izquierdos y un OR de 3.07 para los forámenes derechos. CONCLUSIÓN: este estudio abre el camino para una mayor exploración de los resultados clínicos preoperatorios y postoperatorios en diversos métodos de descompresión quirúrgica guiados por el índice FW/LE. Para mejorar la toma de decisiones, se recomienda realizar una investigación que compare los hallazgos clínicos preoperatorios y postoperatorios en pacientes individuales, teniendo en cuenta sus mediciones del índice FW/LE.

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OBJECTIVE: February 2023 saw major earthquakes in Pazarcik and Elbistan, causing significant devastation in Turkey. Patients were transferred to hospitals in neighboring provinces, with multiple traumas-especially fractures and organ injuries-forming the main reasons for hospital admissions. This study aimed to examine earthquake-related injuries in pediatric and adult populations to understand differences. METHODS: This study analyzed 1,220 adults and 590 pediatric patients with radiological imaging out of 8,704 earthquake trauma cases. Radiological images were assessed independently by two radiologists. Statistical analysis using SPSS examined relationships between variables such as age group and injury type. RESULTS: Results showed 40% of adults and 64% of children had normal radiological findings. Cerebral and extremity traumas were most common in pediatrics, while adults showed more extremity, thoracic, and spinal traumas. Significant differences between adult and pediatric groups were observed in cranial fractures, thoracic and lumbar vertebral fractures, hemopneumothorax, lung contusions, rib fractures, femur and talocalcaneal fractures, and compartment syndrome (p<0.001). CONCLUSION: Earthquake-related injuries may vary between children and adults. Due to children's more flexible anatomical structure, it is believed that earthquake-related injuries occur less frequently in children. In this study, head traumas were more common in children compared to adults. The rate of cranial fractures was significantly higher in children, with a higher incidence of epidural hematoma compared to adults. Spinal traumas were more frequent in adults than in children, attributed to children's greater flexibility reducing the risk of entrapment under rubble. Pediatric thoracic compliance being significantly higher than in adults often resulted in milder chest traumas. However, compartment syndrome was more common in children, with a lower rate of accompanying bone fractures compared to adults. No significant difference was observed between children and adults in maxillofacial, abdominal, and pelvic traumas. These findings provide insights for future disaster healthcare planning and management.

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OBJECTIVE: To demonstrate the clinical and radiographic results of revision knee arthroplasty using a modular system manufactured in Brazil. METHODS: Between November 2010 and January 2017, 31 revision knee arthroplasties were performed in 30 patients, using the MB-V system. Patients were assessed clinically and radiographically after a minimum follow-up of two years using the following scores: Knee Society Score (KSS), Knee Society Score ‒ Function (KSS ‒ Function), and Knee Society Roentgenographic Evaluation System (KSRES). RESULTS: Among the patients, 19 were women. The mean age at surgery was 68 years. The mean follow-up was 9.1 years. There was no aseptic loosening in this period. The mean values of KSS, KSS-function, and KSRES were, respectively, 82, 77, and less than 4. One patient evolved with postoperative flexion instability. Two knees became infected, requiring the removal of the prosthesis and implantation of spacers loaded with antibiotics. One patient developed arthrofibrosis. One patient had a dislocation with full medial collateral avulsion and had to be re-operated with an insert exchange to a CCK liner and medial collateral reconstruction as proposed by Krakow. CONCLUSION: This implant had 93.5 % survivorship (no cases of aseptic failure) and good results in 27 out of 31 knees (87 % of the surgeries).

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BACKGROUND: Radiographs are useful for the initial evaluation of the hip joints. The information can be utilized for the betterment of animal health or other goals such as anatomic studies and gait analysis, among others. Therefore, this study aimed to evaluate radiographic measurements of the hip joint in capuchin monkeys, kept under human care at a reference center for wildlife. METHODS: Twelve capuchin monkeys (Sapajus spp.) (three adult males, seven adult females, and two sub-adult females) were evaluated. Ventrodorsal radiographic views were taken under chemical restraint. All measurements on the digital images were performed in triplicate by one examiner. RESULTS AND CONCLUSIONS: None of the measurements evaluated were statistically different between males and females. No statistical differences were found between hind limbs. The mean (±SD) Norberg angle was 104.92° (±2.82°) and the Wiberg angle was 15.26° (±1.86°). The percentage of the femoral head covered by the acetabulum was 68.57% (±3.65%) and the acetabular index depth to width ratio was 54.66% (±3.85%). In conclusion, the radiographic measurements showed certain morphological features of the hip joint in Sapajus spp. that contribute to improving species knowledge.

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OBJECTIVE: The objective of this study is to correlate clinical symptoms and functionality, using the KOOS (Knee Injury and Osteoarthritis Outcome Score) and KSS (Knee Society Score System) scores, with the radiographic changes, using the Kellgren-Lawrence classification, in patients with knee osteoarthritis and indications for Total Knee Arthroplasty (TKA). METHODS: 120 patients (189 knees) with gonarthrosis and indications for TKA were included in the study. Demographic questionnaires were applied, and clinical and functional assessment was carried out using the KOOS and KSS scores. Knee radiographs were taken and graded according to Kellgren-Lawrence. The clinical scores were compared with the radiographic classification to establish a correlation between these two measurements. Statistical analysis was performed using the τ-Kendall correlation test. RESULTS: Weak and inversely proportional correlations were found between the clinical scores and the radiographic classification. Among clinical scores evaluated, KSS showed the highest correlation with Kellgren-Lawrence classification (τ = -0.356; p < 0.001), followed by KOOS-quality of life (τ = -0.176; p = 0.004), KOOS-total score (τ = -0.166; p = 0.004), KOOS-function in daily living (τ = -0.160; p = 0.005) and KOOS-symptoms (τ = -0.159; p = 0.006). KOOS-pain (τ = -0.149; p = 0.01) and KOOS-sport and recreation function (τ = -0.142; p = 0.025) scores had the weakest correlations. CONCLUSION: There is a weak correlation between the clinical-functional scores of TKA candidates and their radiographic classification by Kellgren-Lawrence. Among clinical scores evaluated, KSS had the strongest negative correlation with the radiographic classification.

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INTRODUCTION: total hip arthroplasty (THA) is one of the most performed surgeries worldwide, with high satisfaction rates. The orientation of the acetabular component has a direct impact on the risk of dislocation, recently with the support of robotic surgery the margin of error in implant placement has decreased; however, the conventional technique even without fluoroscopic support continues to have satisfactory results within the safety zone. MATERIAL AND METHODS: retrospective, cross-sectional, descriptive case series of patients treated with THA at Hospital General Xoco between 2022 and 2024. Degrees of anteversion and inclination were measured with Widmer's method on postoperative radiographs. RESULTS: the radiographs of 113 patients were studied, 80 female and 33 male, with a mean age of 63.2 ± 13.01 years (95% CI: 60.6-65.4), a mean inclination of 42.2° ± 8.1° (95% CI: 40.7-43.2) and anteversion of 14.3° ± 8.5° (95% CI: 12.5-15.4); 76% of the population was within Lewinnek safe zone; by etiology: osteoarthrosis 74%, sequelae of dysplasia 68% and intracapsular fracture 82%; difference between the values of the affected side: left 65%, right 83%, of 3.9° and 4.7°/6.4o and 9° in relation to the overall values of the population. CONCLUSION: in our population undergoing THA, without the use of robotic technique or support of imaging studies, anteversion and inclination figures were recorded within the Lewinnek safety parameters with a conventional method.

INTRODUCCIÓN: la artroplastía total de cadera (ATC) es una de las cirugías más realizadas a nivel mundial, con altos porcentajes de satisfacción. La orientación del componente acetabular tiene impacto directo en el riesgo de luxación; recientemente, con el apoyo de la cirugía robótica, el margen de error en la colocación de los implantes ha disminuido; sin embargo, la técnica convencional, incluso sin apoyo fluoroscópico, continúa teniendo resultados satisfactorios dentro de la zona de seguridad. MATERIAL Y MÉTODOS: serie de casos retrospectiva, transversal y descriptiva, de pacientes tratados con ATC en Hospital General Xoco entre 2022 y 2024. Se midieron los grados de anteversión e inclinación con el método de Widmer en las radiografías postoperatorias. RESULTADOS: se estudiaron las radiografías de 113 pacientes, 80 mujeres y 33 hombres, con edad media de 63.2 ± 13.01 años (IC95%: 60.6-65.4), se obtuvo una inclinación media de 42.2° ± 8.1° (IC95%: 40.7-43.2) y anteversión de 14.3° ± 8.5° (IC95% 12.5-15.4); 76% de la población se encontraba dentro de la zona segura de Lewinnek; por etiología: osteoartrosis 74%, secuelas de displasia 68% y fractura intracapsular 82%; diferencia entre los valores del lado afectado: izquierdo 65%, derecho 83%, de 3.9° y 4.7°/6.4° y 9° en relación con los valores globales de la población. CONCLUSIÓN: en nuestra población sometida a ATC, sin uso de técnica robótica o apoyo de estudios de imagen, se registraron cifras de anteversión e inclinación dentro de los parámetros de seguridad de Lewinnek con un método convencional.

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OBJECTIVE: The primary objective was to assess the diagnostic accuracy of a deep learning-based artificial intelligence model for the detection of acute appendicular fractures in pediatric patients presenting with a recent history of trauma to the emergency department. The secondary goal was to examine the effect of assistive support on the emergency doctor's ability to detect fractures. METHODS: The dataset was 5,150 radiographs of which 850 showed fractures, while 4,300 radiographs did not show any fractures. The process utilized 4,532 (88%) radiographs, inclusive of both fractured and non-fractured radiographs, in the training phase. Subsequently, 412 (8%) radiographs were appraised during validation, and 206 (4%) were set apart for the testing phase. With and without artificial intelligence assistance, the emergency doctor reviewed another set of 2,000 radiographs (400 fractures and 600 non-fractures each) for labeling in the second test. RESULTS: The artificial intelligence model showed a mean average precision 50 of 89%, a specificity of 92%, a sensitivity of 90%, and an F1 score of 90%. The confusion matrix revealed that the model trained with artificial intelligence achieved accuracies of 93 and 95% in detecting fractures, respectively. Artificial intelligence assistance improved the reading sensitivity from 93.7% (without assistance) to 97.0% (with assistance) and the reading accuracy from 88% (without assistance) to 94.9% (with assistance). CONCLUSION: A deep learning-based artificial intelligence model has proven to be highly effective in detecting fractures in pediatric patients, enhancing the diagnostic capabilities of emergency doctors through assistive support.

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BACKGROUND: Spondyloarthritis (SpA) encompasses a spectrum of immune-mediated inflammatory conditions primarily affecting the axial skeleton, including sacroiliitis and spondylitis, each with distinct features. This study aimed to investigate imaging disparities, focusing on sacroiliac magnetic resonance and spine radiography, across phenotypes and between males and females in axial SpA. METHOD: A cross-sectional study was conducted to assess clinical data, laboratory findings, magnetic resonance imaging (MRI) scores of sacroiliac joints using the Spondyloarthritis Research Consortium of Canada (SPARCC) and Sacroiliac Joint Structural Score (SSS), and cervical and lumbar spine radiographs utilizing the Modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). The study aimed to compare these parameters between two groups: axial spondyloarthritis (axSpA, radiographic and non-radiographic) and axial psoriatic arthritis (axPsA), as well as between males and females. RESULTS: Ninety-four patients were included, with 62 patients in the axSpA group and 32 patients in the axPsA group. There were no differences in disease activity, mobility, radiographic damage in the spine (Modified Stoke Ankylosing Spondylitis Spine Score- mSASSS), or sacroiliac magnetic resonance imaging (MRI) scores (Spondyloarthritis Research Consortium of Canada Magnetic Resonance Imaging Index - SPARCC and Sacroiliac Joint Structural Score - SSS) between the two phenotypes. Regarding sex, in imaging exams, men had higher mSASSS (p = 0.008), SSS (p = 0.001), and fat metaplasia (MG) score based on SSS (p = 0.001), while women had significantly higher SPARCC scores (p = 0.039). In the male group, the presence of HLA-B27 allele had an impact on more structural lesions on MRI (SSS), p = 0.013. CONCLUSION: In this study, imaging of sacroiliac joints and spine in patients with axial SpA did not show differences in phenotypes but did reveal differences based on sex, which may have an impact on future diagnostic recommendations. Further studies are needed to confirm these findings.

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Developmental Dysplasia of the Hip (DDH) has an incidence of 3.9% in Chile, and comprises a pathological spectrum from acetabular dysplasia to congenital dislocation of the joint, and can affect all components of the hip. Without treatment, degenerative changes occur progressively, so early management is essential. In cases of absence of treatment, total hip arthroplasty becomes the only therapeutic alternative, becoming a great challenge for the treating team. We present a case of a 56-year-old female patient, with a history of bilateral coxarthrosis secondary to bilateral CDD, referred to the specialty due to claudication and long-standing coxalgia, her study was compatible with advanced coxarthrosis associated with sequelae of bilateral high congenital dislocation. She underwent left total hip arthroplasty (THA), restoring the center of rotation of the joint, associated with sub trochanteric osteotomy to achieve femoral descent without neurological injury. In a second time, after 6 months, a right THA is performed, repeating the previous procedure, with excellent clinical and radiological results in both surgeries. Evolution is shown after 3 years, showing the total remodeling of the femoral osteotomies, with no evidence of osteolysis or wear of the prosthetic components, with excellent clinical results, highlighting gait with minimal claudication.

La Displasia del Desarrollo de la Cadera (DDC) presenta una incidencia de un 3.9% en Chile, y comprende un espectro patológico desde la displasia acetabular hasta la luxación congénita de la articulación, pudiendo afectar a todos los componentes de la cadera. Sin tratamiento se producen cambios degenerativos de forma progresiva, por lo que el manejo precoz es fundamental. En casos de ausencia de tratamiento, la artroplastia total de caderas se transforma en la única alternativa terapéutica, transformándose en un gran desafío para el equipo tratante. Se presenta un caso de una paciente femenina de 56 años, con antecedente de coxartrosis bilateral secundaria a DDC bilateral, derivada a la especialidad por claudicación y coxalgia de larga data, su estudio resulta compatible con coxartrosis avanzada asociada a secuelas de luxación congénita alta bilateral. Es sometida a artroplastia total de cadera (ATC) izquierda, restaurando el centro de rotación de la articulación, asociado a osteotomía sub trocantérica para lograr descenso femoral sin lesión neurológica. En un segundo tiempo, luego de 6 meses se realiza ATC derecha, repitiendo el procedimiento anterior, con excelentes resultados clínicos y radiológicos en ambas cirugías. Se muestra evolución a los 3 años, evidenciándose la total remodelación de las osteotomías femorales, sin evidencias de osteolisis ni desgaste de los componentes protésicos, con excelentes resultados clínicos, destacando marcha con mínima claudicación.

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El linfoma cardiaco primario, un tipo extremadamente raro de linfoma no Hodgkin de células B, presenta una incidencia aproximada de 0.02-2% entre los tumores cardíacos malignos. Se asocia frecuentemente con manifestaciones como alteraciones del ritmo cardíaco, derrame pericárdico refractario y masas cardiacas. El diagnóstico definitivo se logra mediante biopsia, siendo esencial descartar diseminación hematógena con PET-CT. La literatura indica una predominancia de afectación de las cavidades derechas y una supervivencia que varía significativamente según la afectación del ventrículo izquierdo y la presencia de arritmias. Las opciones terapéuticas no están bien definidas, pero la quimioterapia como R-CHOP ha mostrado eficacia, aunque el pronóstico generalmente es pobre debido a complicaciones como progresión de la enfermedad, arritmias y sepsis. Este caso subraya la importancia de considerar el linfoma cardiaco en pacientes con síntomas cardiacos inexplicables, destacando la necesidad de un enfoque diagnóstico y terapéutico multidisciplinario y específico.

Primary cardiac lymphoma, an extremely rare type of B-cell non-Hodgkin lymphoma, has an incidence of approximately 0.02-2% among malignant cardiac tumors. It is frequently associated with manifestations such as cardiac rhythm disturbances, refractory pericardial effusion and cardiac masses. Definitive diagnosis is achieved by biopsy, being essential to rule out hematogenous dissemination with PET-CT. The literature indicates a predominance of right chamber involvement and survival that varies significantly according to left ventricular involvement and the presence of arrhythmias. Therapeutic options are not well defined, but chemotherapy such as R-CHOP has shown efficacy, although the prognosis is generally poor due to complications such as disease progression, arrhythmias and sepsis. This case underscores the importance of considering cardiac lymphoma in patients with unexplained cardiac symptoms, highlighting the need for a multidisciplinary and specific diagnostic and therapeutic approach.

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PURPOSE: The purpose of this study was to assess clinical and functional outcomes as well as the prosthesis survival rates of the U2 Knee system in primary total knee arthroplasty (TKA) with a minimum follow-up of four years. METHODS: We retrospectively analyzed 560 consecutively primary TKA performed between 2015 and 2019 due to osteoarthritis with a mean follow-up of 5.4 ± 1.1 years. The clinical outcomes were assessed using the knee society score (KSS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Radiographic outcomes were assessed using the American knee society's roentgenographic evaluation system. Prosthetic survival was calculated using the Kaplan-Meier method. RESULTS: Postoperative KSS showed significant improvement at one year (Clinical: 37.4 ± 4.1 vs. 91.9 ± 3.7; p < 0.01; Functional: 41.2 ± 3.3 vs. 90.6 ± 4.8; p = < 0.01), with these improvements maintained throughout the follow-up period. The WOMAC score improved from 60 ± 10.1 preoperatively to 10.9 ± 8.3 (p = 0.02) at the end of the follow-up. There were 20 (3.7%) knees with radiolucent lines around the implant (< 2 mm), and none showed evidence of loosening. There were six (1.1%) revisions-four due to prosthetic joint infections and two due to periprosthetic femur fracture. The prosthetic survival was 97.8% at the study closure. CONCLUSION: The U2 knee system demonstrates effective and safe performance for primary TKA with significant improvements in functional scores, patient-reported outcomes, and a promising prosthesis survival rate at mid-term follow-up. We will continue with the series analysis to assess the long-term outcomes.

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PURPOSE: To develop and assess three-dimensional models of physeal fractures in dog femurs (3D MPFDF) using radiographic imaging. METHODS: The study was conducted in three phases: development of 3D MPFDF; radiographic examination of the 3D MPFDF; and comparative analysis of the anatomical and radiographic features of the 3D MPFDF. RESULTS: The base model and the 3D MPFDF achieved high fidelity in replicating the bone structures, accurately maintaining the morphological characteristics and dimensions such as length, width, and thickness, closely resembling natural bone. The radiographs of the 3D MPFDF displayed distinct radiopaque and radiolucent areas, enabling clear visualization of the various anatomical structures of the femur. However, in these radiographs, it was challenging to distinguish between the cortical and medullary regions due to the use of 99% internal padding in the printing process. Despite this limitation, the radiographs successfully demonstrated the representation of the Salter-Harris classification. CONCLUSIONS: This paper presents a pioneering project focused on technological advancement aimed at developing a method for the rapid and cost-effective production of three-printed models and radiographs of physeal fractures in dogs.

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SUMMARY: The present study aimed to investigate the utility of the proximal femur in the forensic age estimation by assessing changes in bone densities through radiographs. Using Otsu's threshold, bone density was quantified by counting all white pixel values within selected regions of interest, which include femoral head (FH), femoral neck (FN), Ward's triangle (WT), and greater trochanter (GT) from 354 left femora of Northern Thai descent. The pixel width of medullary cavity (MC) was also estimated. Furthermore, the study evaluated the performance of linear regression (LR) models for age estimation from radiographic images of proximal femora. Negative correlations were observed between FH, FN, WT, and GT pixel intensity with the age-at-death of the samples, with females exhibiting stronger correlations than males. Moreover, a positive correlation was found between age and MC width in female samples, while male MC widths did not show any relationship with increasing age. The results showed a slight difference between the LR model applied to both sexes, which integrated all variables, and the alternative configuration that only utilized relevant attributes. Both models exhibited similar performance, with a narrow range of root mean square error (RMSE) values, ranging from 12.67 to 12.71 years, and a correlation coefficient range of 0.51 to 0.52. For females, the LR model with FN and WT as selected attributes (RMSE = 11.85 years, correlation coefficient = 0.65) performed decently, while for males, the LR model with all variables showed RMSE of 12.52 years and correlation coefficient of 0.46. This study showcased the potential application of pixel intensity in predicting age.

El presente estudio tuvo como objetivo investigar la utilidad del fémur proximal en la estimación forense de la edad mediante la evaluación de cambios en las densidades óseas a través de radiografías. Utilizando el umbral de Otsu, la densidad ósea se cuantificó contando todos los valores de pixeles blancos dentro de regiones de interés seleccionadas, que incluyen la cabeza femoral (CF), el cuello femoral (CF), el triángulo de Ward (WT) y el trocánter mayor (TM) de 354 fémures izquierdos de ascendencia del norte de Tailandia. También se estimó el ancho de pixeles de la cavidad medular (CM). Además, el estudio evaluó el rendimiento de modelos de regresión lineal (RL) para la estimación de la edad a partir de imágenes radiográficas de fémur proximal. Se observaron correlaciones negativas entre la intensidad de los pixeles CF, CF, WT y TM con la edad de muerte, y las mujeres exhibieron correlaciones más fuertes que los hombres. Además, se encontró una correlación positiva entre la edad y el ancho del CM en muestras de mujeres, mientras que el ancho del CM del hombre no mostró ninguna relación con el aumento de la edad. Los resultados mostraron una ligera diferencia entre el modelo RL aplicado a ambos sexos, que integraba todas las variables, y la configuración alternativa que sólo utilizaba atributos relevantes. Ambos modelos mostraron un rendimiento similar, con un rango estrecho de valores del error cuadrático medio (RMSE), que oscilaba entre 12,67 y 12,71 años, y un rango de coeficiente de correlación de 0,51 a 0,52. Para las mujeres, el modelo RL con CF y WT como atributos seleccionados (RMSE = 11,85 años, coeficiente de correlación = 0,65) tuvo un desempeño satisfactorio, mientras que para los hombres, el modelo RL con todas las variables mostró un RMSE de 12,52 años y un coeficiente de correlación de 0,46. Este estudio mostró la posible aplicación de la intensidad de los pixeles en la predicción de la edad.

RESUMO

The anatomical variations of the maxillary septum and the septal bullae can generate challenges during the interpretation of radiographs of the horses' heads and make it difficult to accurately identify the sites affected in sinus disorders. The description of the radiographic appearance of these structures is currently scarce in the scientific literature. This work aims to describe the anatomical and radiographic characteristics of the maxillary septum and maxillary septal bullae in horses. Six chemically preserved equine cadaver heads were used which, after being submitted to the maxillary osseous flap, the maxillary septum and its respective bullae were identified. Radiographic examinations before and after contrast impregnation on these structures were performed. The positioning of the maxillary septum varied between the anatomical specimens and between the sides of the same specimen. The 30° oblique dorsoventral lateral and lateral projections allowed the identification of the maxillary septum and septal bullae. However, the bullae remained superimposed on the dental arches in the dorsoventral projections with the mandible in a neutral position or with the mandible displaced. The oblique offset radiographic positioning was suggested and proved effective for the examination of the maxillary septal bullae, where the mandible was displaced to the side of the bullae to be examined, and the radiographic beam inclined in the same direction. The maxillary septum and its bullae could be properly identified in a macroscopic way after the osseous flap and the contrasted radiographic examination allowed its adequate interpretation. Variations in size and position are considered normal for the equine species.