BACKGROUND: Sclerotherapy has shown superior efficacy among the nonsurgical options for managing digital mucous cysts (DMC). Notably, previous research has indicated that bleomycin offers a more favorable side-effect profile and similar efficacy to conventional sclerosing agents.
OBJECTIVE: This study aimed to assess the efficacy and safety of bleomycin intralesional injection (ILI) for treating DMC through a comparative analysis of corticosteroid ILI and surgical excision.
METHODS: We retrospectively reviewed electronic medical records and clinical photographs. Telephone interviews were conducted to further investigate long-term treatment efficacy, safety, and overall treatment satisfaction.
RESULTS: Ten patients underwent surgical excision, and 13 and 15 patients received bleomycin and corticosteroid ILI, respectively. Both surgical excision and bleomycin ILI demonstrated superior treatment efficacy compared to corticosteroid ILI. No statistically significant difference in the treatment effectiveness between surgical excision and bleomycin ILI was observed. No significant adverse effects were observed. In the survey, the level of satisfaction was the highest for bleomycin ILI, followed by surgical excision and corticosteroid ILI.
CONCLUSIONS: This study revealed that bleomycin ILI exhibits a treatment efficacy higher than that of corticosteroid ILI and slightly lower than that of surgical excision, without any side effects. Therefore, bleomycin ILI is a safe and effective therapeutic option for the treatment of DMC.

The anterior cruciate ligament (ACL) is a commonly injured ligament in the knee. Bone tunnel widening is a known phenomenon after soft-tissue ACL reconstruction and etiology and the clinical relevance has not been fully elucidated. Osteoconductive compounds are biomaterials providing an appropriate scaffold for bone formation such as a demineralized bone matrix. Osteoinductive materials contain growth factors stimulating bone lineage cells and bone growth. A possible application of osteoinductive/osteoconductive (OIC) material is in ACL surgery. We hypothesized that OIC placed in ACL bone tunnels: (1) reduces tunnel widening, (2) improves graft maturation, and (3) reduces tunnel ganglion cyst formation. To test this hypothesis, this study evaluated the osteogenic effects of demineralized bone matrix (DBM) and platelet-rich plasma (PRP) on tunnel widening, graft maturation, and ganglion cyst formation. This was a randomized controlled clinical trial pilot study. A total of 26 patients that elected to have ACL reconstruction surgery were randomized between the OIC and control group. Measurements of tunnel expansion and graft-tunnel incorporation were conducted via the quantitative image analysis of MRI scans performed at six months after surgery for both groups. No patients had adverse post-operative reactions or infections. The use of OIC significantly reduced tunnel widening (p < 0.05) and improved graft maturation (p < 0.05). Patients treated with OIC had a significantly lower prevalence of ganglion cyst compared to the control group (p < 0.05). The use of OIC has measurable effects on the reduction of tunnel widening, improved graft maturation, and decreased size of ganglion cyst after ACL reconstruction. This study explored the utilization of biologics to minimize bone tunnel widening in ACL reconstruction surgery.

Myopericytoma (MPC) is an uncommon benign neoplasm of the skin and soft tissues belonging to a spectrum of tumors that are histologically recognized by their distinctive perivascular myoid cell differentiation. These distinct tumors are more prevalent among middle-aged males, and they arise more frequently in the subcutaneous tissue of the four extremities. In this paper, myopericytoma is reported in a 59-year-old Saudi male, presented with a painless small cyst involving the left ankle suspected clinically to be a ganglion cyst. Following surgical excision of the cyst, the diagnosis of myopericytoma was made based on the histopathological pattern of the disease. This paper focuses on the clinical and histopathological findings of myopericytoma and emphasizes the importance of immunohistochemistry as well as molecular testing in reaching the final diagnosis.

UNASSIGNED: Numerous pathological processes involve synovium and periarticular tissues that are characteristic and in some cases specific to a particular disease. Synovial fluid is a thick, stringy fluid found in the cavity of synovial joint. Examination of the synovium plays a key role in the diagnosis of many joint diseases.
UNASSIGNED: The aim of this study was to study the spectrum of synovial lesions on fine needle aspiration cytology (FNAC) and to compare the cytological diagnosis with histopathological findings.
UNASSIGNED: This retrospective diagnostic analytical study was carried out in the Department of Pathology. Sixty-six patients with suspected synovial lesions referred from other departments who underwent FNAC during 1 year from January 2017 to December 2017 were included in the study. The slides along with records of the patients were retrieved and findings recorded. Histopathological evaluation was performed wherever possible and compared with cytological diagnosis.
UNASSIGNED: Non-neoplastic lesions accounted for 80.3% cases followed by benign tumors (15.2%). Ganglion cyst was the commonest non-neoplastic lesion (60.6%, 40/66), while tenosynovial giant cell tumor was the commonest neoplasm (12.1%, 8/66) observed in our study. Solitary case of synovial sarcoma was also observed. Histopathological evaluation was performed in 14 cases and FNAC had overall diagnostic accuracy of 85.7% in diagnosis of these lesions.
UNASSIGNED: FNAC is a useful tool with high diagnostic accuracy in the evaluation of synovial lesions.

Background: Despite the role of one\'s hands in human function and quality of life, financial disincentives to perform common hand procedures in patients with government-sponsored insurance plans may lead to longer wait times and decreased access to care. Here, we identify the variations in reimbursement for 4 common hand procedures as a step toward understanding these financial implications to develop safeguards to minimize effects on access to care. Methods: Billing data were collected over a 10-year period for patients undergoing carpal tunnel release (open, Current Procedural Terminology 64721; endoscopic, 29848), cubital tunnel release (64718), ganglion cyst excision (25111), and interposition arthroplasty (25447). Patients were placed into cohorts according to insurance type-private insurance, Medicare, Medicaid, or worker\'s compensation-and these were directly compared. Results: A total of 3489 procedures between 2005 and 2015 were identified in this study (carpal tunnel 65.8%, cubital tunnel 28.7%, ganglion cyst excision 4.1%, and interposition arthroplasty 13.8%). In all, 54.7% of patients had private insurance; 26.3%, Medicare; 10.5%, worker\'s compensation; and 8.5%, Medicaid. Reimbursement, as a percentage of charge, differed significantly by payor type for all cases and by procedure. On average, worker\'s compensation plans reimbursed 65.5% of submitted charges; private insurance, 50.6%; Medicare, 25.1%; and Medicaid, 24.6%. Conclusions: We found that wide variations in reimbursement for common hand procedures exist and may preclude some surgeons from offering certain procedures to a subset of patients. Understanding these discrepancies is a key first step in minimizing a potential care delivery disparity for this patient population.