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Background We investigated whether magnetic resonance imaging (MRI) scans can accurately diagnose arthritis of the acromioclavicular joint (ACJ) because it has recently been suggested that bone marrow oedema on MRI scans is a predictive sign of symptomatic ACJ arthritis. Methods The MRI scans of 43 patients (50 shoulders) who underwent ACJ excision for clinically symptomatic ACJ arthritis were compared to a control group of 43 age- and sex-matched patients (48 shoulders) who underwent an MRI scan for investigation of shoulder pain but did not have clinical symptoms or signs of ACJ arthritis. The scans were evaluated by an experienced musculoskeletal radiologist, who was blinded to the examination findings. Results Bone marrow oedema was present in only 15 (30%) shoulders in the ACJ excision group, although this was higher than the six shoulders in the asymptomatic group (p = 0.03). Forty-one (82%) shoulders in the symptomatic group had grade III/IV ACJ arthritis compared to 31 (65%) in the asymptomatic group (p = 0.05). However, 44 out of 48 (92%) shoulders in the asymptomatic group had signs of osteoarthritis on MRI scans. Conclusions In contrast to recent reports, the present study shows that MRI is not helpful in making the diagnosis of ACJ arthritis. A focused history and clinical examination should remain the mainstay for surgical decision making. Level of evidence Level 3 [ABSTRACT FROM AUTHOR]

This paper describes the Arrhythmia Monitoring System (AMS), a working wireless telemetry system test bed developed at the U.S. National Aeronautics and Space Administration and Case Western Reserve University's Heart & Vascular Center. AMS collects real-time electrocardiogram (ECG) signals from mobile or home-bound patients, combines Global Positioning System (GPS) location data and transmits both to a remote station for display and monitoring. The central server performs several functions, including data compression, location awareness via GPS signals and rudimentary arrhythmia detection. This modular design supports common research goals involving human health in space as well as on earth. Cardiac dysrhythmias present a major health risk to astronauts. An ECG represents the heart muscle's electrical activity as it is recorded from surface sensors placed in standard locations on the body. The central server is the logical midpoint between a patient and the call center. Device capabilities and a wireless service provider drive session management. Wireless transmission of ECG tightly coupled with GPS coordinates kindles debate over medical and location privacy. The privacy issues being ironed out involve ownership of the location information and control or disclosure with or without customer consent.

Aims: The primary aim of this study was to report the radiological outcomes of patients with a dorsally displaced distal radius fracture who were randomized to a moulded cast or surgical fixation with wires following manipulation and closed reduction of their fracture. The secondary aim was to correlate radiological outcomes with patient-reported outcome measures (PROMs) in the year following injury., Methods: Participants were recruited as part of DRAFFT2, a UK multicentre clinical trial. Participants were aged 16 years or over with a dorsally displaced distal radius fracture, and were eligible for the trial if they needed a manipulation of their fracture, as recommended by their treating surgeon. Participants were randomly allocated on a 1:1 ratio to moulded cast or Kirschner wires after manipulation of the fracture in the operating theatre. Standard posteroanterior and lateral radiographs were performed in the radiology department of participating centres at the time of the patient's initial assessment in the emergency department and six weeks postoperatively. Intraoperative fluoroscopic images taken at the time of fracture reduction were also assessed., Results: Patients treated with surgical fixation with wires had less dorsal angulation of the radius versus those treated in a moulded cast at six weeks after manipulation of the fracture; the mean difference of -4.13° was statistically significant (95% confidence interval 5.82 to -2.45). There was no evidence of a difference in radial shortening. However, there was no correlation between these radiological measurements and PROMs at any timepoint in the 12 months post-injury., Conclusion: For patients with a dorsally displaced distal radius fracture treated with a closed manipulation, surgical fixation with wires leads to less dorsal angulation on radiographs at six weeks compared with patients treated in a moulded plaster cast alone. However, the difference in dorsal angulation was small and did not correlate with patient-reported pain and function., Competing Interests: The authors disclose that the UK National Institute for Health Research (NIHR) provided grant funding for the DRAFFT2 trial. The research was supported by the NIHR Oxford Biomedical Research Centre (BRC). In addition, M. L. Costa declares that the University of Oxford receives research grant funding from the NIHR and Wellcome for research into musculoskeletal trauma., (© 2024 Costa et al.)

The intra-aortic balloon pump (IABP) is a tool to help improve myocardial perfusion, reduce afterload, and decrease myocardial demand by reducing cardiac work. We describe a unique case of an IABP placement in a pregnant woman in her third trimester with a non-ST elevation myocardial infarction. The IABP allowed safe delivery of the fetus by cesarean section prior to a successful percutaneous intervention for complex two-vessel coronary artery disease. This case report also describes the first-time use of an IABP during cesarean section.