Absence of Posttraumatic Bone Marrow Edema in the Setting of Preeclampsia.

Magnetic resonance imaging is a powerful tool in the diagnosis of missed or occult fractures on radiographic and computed tomographic (CT) imaging, through the detection of bone marrow edema. Although radiologists often rely on bone marrow edema as a guide for diagnosing subtle underlying fractures, it is important to recognize its limitations as a diagnostic metric. We present a rare case demonstrating the absence of bone marrow edema after acute trauma and confirmed Lisfranc fracture in a patient with preeclampsia and propose an interesting physiologic mechanism to explain this manifestation.

Tales of Mentoring in Radiology: The Experience of Residents and Mentors at a Single Academic Program.

PURPOSE: To investigate the utility of mentoring groups in radiology residency. METHODS: Five assistant professors of Radiology and 20 radiology residents were divided into 5 groups. One resident from each academic year was randomly paired with a mentor group. Three 1-hour group mentoring sessions took place over the year. Upon completion of the project an anonymous Quality Improvement survey of 20 questions were sent out to participants to assess the utility of these mentoring sessions. RESULTS: Four mentors out of 5 responded. All 4 had prior neutral and positive experiences as mentees involving career advice and subspecialty choice. During this experience all mentors had a positive experience. The majority found it helpful to have residents of different levels in their group to allow for peer to peer mentoring and all thought the mentoring program should continue. The most common topics they covered during the sessions were career advice and specialty choice. Sixteen residents out of 20 responded. The majority had had a previous mentor experience which was mostly positive or very positive and predominantly career and/or research related. Almost all of them had a positive or very positive mentoring experience this year. The high majority found that having residents of different levels was beneficial. Topics that mentoring sessions helped mostly with were career advice, work life balance and study skills. All of the mentees thought the mentoring program should continue. CONCLUSIONS: Mentoring groups can be a valuable addition to residency training, especially in helping with career advice and work life balance.

Sarcopenia is associated with longer hospital stay and multiorgan dysfunction in alcoholic hepatitis.

INTRODUCTION: Excessive alcohol consumption has steadily risen to become the third leading cause of preventable death in the USA. One consequence of heavy alcohol use recently under considerable investigation is alcoholic hepatitis. Although many risk factors for developing alcoholic hepatitis have been documented, our aim in this study was to examine the potential association between sarcopenia and severity, mortality, 30 days readmission rate, complication, infections and length of hospital stay in alcoholic hepatitis patients. METHODS: A retrospective analysis was performed at a large, academic hospital in 194 alcoholic hepatitis patients aged 18-60 who had cross-sectional computed tomography imaging and met our clinical definition of alcoholic hepatitis. The fifth percentile of the psoas muscle index was used as a cutoff for sarcopenia. RESULTS: One hundred ninety-four patients met the criteria for alcoholic hepatitis and had cross-sectional imaging. Higher Model for End-Stage Liver disease score was found in the sarcopenia group when compared to the non-sarcopenia group (mean Model for End-Stage Liver disease 21.5 and 24.2, respectively, P = 0.03). Sarcopenia also correlated with significantly longer hospital stay; the average length of stay in the sarcopenia group was 17.2 days while the non-sarcopenia patients had an average of 12.4 days. We found higher risk of developing pneumonia, sepsis and hepatic encephalopathy in sarcopenic patients. CONCLUSION: Alcoholic hepatitis patients with sarcopenia have significantly worse outcomes when compared with the patients without sarcopenia, including a severe form of alcoholic hepatitis, longer hospital stays, higher risk of developing pneumonia, sepsis and hepatic encephalopathy.