UNASSIGNED: The wrist is a complex joint that plays a role in several everyday tasks. Various radiological indices have been created to assess the alignment and structure of the wrist using standard X-ray images. Nevertheless, these indicators may differ based on variables such as age, gender, ethnicity, handedness, and wrist position. This research aimed to assess the radiological indices of the wrist in a group of healthy people from Jordan and investigate the impact of age and gender on these indices.
UNASSIGNED: We obtained data from a sample of 385 patients who presented at our hospital with minor non-specific wrist pain and satisfied the specified criteria for inclusion. We conducted measurements of radial inclination, radial height, volar tilt, ulnar variance, and carpal height ratio using both anteroposterior and lateral views of the wrist. We used linear regression and independent sample t-test to examine the correlation between age, gender, and radiological indicators. The reliability of the measurements was assessed using the intraclass correlation coefficient (ICC).
UNASSIGNED: Our study revealed a negative correlation between age and carpal height ratio (r = -0.13, p = 0.03). However, no significant gender differences were seen in any of the radiological indices (p > 0.05). Our findings indicate that ulnar variance had the greatest level of reliability across observers, with an intra-observer intraclass correlation coefficient (ICC) of 0.95 and an inter-observer ICC of 0.8. Conversely, volar tilt exhibited the lowest inter-observer reliability, with an ICC of 0.1.Our results provide a valuable point of reference for the wrist morphology and alignment in the Jordanian population. Our suggestion is that the carpal height ratio might indicate alterations in the wrist joint due to aging, whereas ulnar variation may serve as a dependable indicator of wrist alignment. We suggest doing more research to investigate the biological and anatomical factors behind these results and to compare them with other demographic groups.

Prader-Willi syndrome (PWS) is an exceedingly rare congenital syndrome of chromosome 15 that presents multiple comorbidities in said individuals. The associated quality of life for those with the disease is often severely diminished; more tragically, mortality associated with the disease is also increased. Pulmonary embolism (PE) is highly associated with mortality and has been shown to be more prevalent in patients with PWS. This case report details a patient with PWS who survived an acute saddle PE and looks to bring more clinical knowledge that can be applied when dealing with individuals with PWS.

We describe a case report of a 13 year-old a gymnastic athlete who was diagnosed with an olecranon stress fracture associated with mild medial epicondyle apophysitis, Following a brief review of the literature on this case, the researchers call attention to the significance of and imaging assessment especially MR in determining the correct diagnosis and identifying concomitant injuries. MRI findings concluded firstly a marked bone marrow edema seen at the posterior medial aspect of the olecranon with linear low signal traversing the olecranon related to a stress fracture. Secondly, subchondral linear low signal and bone marrow edema at the radial head related to another stress fracture/reaction injury. Thirdly, bone marrow edema at the medial apophysis with overlying soft tissue edema suggestive for medial epicondylitis.

UNASSIGNED: Quantitatively define the radiographic locations of the major soft-tissue attachments about the elbow.
UNASSIGNED: In 10 cadaveric elbows, the attachments of the medial ulnar collateral ligament, lateral ulnar collateral ligament, annular ligament, triceps, and biceps were marked with radiopaque spheres. Measurements were made on calibrated AP and lateral fluoroscopic images from known osseous landmarks.
UNASSIGNED: On AP radiographs; the anterior bundle of the MUCL (aMUCL) measured 28.6mm (95% CI, 27. 5-29.8mm) from the humeral attachment to the midpoint of the MUCL ridge on the ulna and 14.3mm, (95% CI 13.0-15.5) to the olecranon. The LUCL was 39.9mm (95% CI, 38.6 - 41.1mm) from the humeral attachment to the supinator crest attachment and 8.9mm (95% CI, 8.1-9.8mm) to the lateral epicondyle. On the lateral radiographs, the humeral attachment of the aMUCL to the medial coronoid was 27.1mm (95% CI, 25.9-28.2mm) and 9.3mm (95%CI, 17.5 -21.2mm) to the tip. The LUCL humeral attachment to the supinator crest was 45.4mm (95%CI, 44.1-46.8mm). The LUCL humeral attachment was located 8.9mm (95%CI, 8.0-9.7mm) posterior from the anterior humeral line.
UNASSIGNED: The soft-tissue attachments about the elbow were reproducibly demonstrated on radiographs in relation to osseous landmarks and radiographic lines. The radiographic relationships will allow for improved identification of the ligament and tendon attachment sites of the elbow for intraoperative assessment and postoperative evaluation following reconstruction.

Ankles are the most common site of injury in lower limb fractures. Despite this, the classification of the Maisonneuve fracture is still highly controversial, perhaps due to its low incidence. Typically described as a proximal fibular fracture with associated injury to the syndesmosis and medial structures secondary to an external rotation mechanism, the injury often necessitates surgical intervention to restore joint stability for good functional outcomes. A 32-year-old lady sustained a pronation external rotation injury resulting in a proximal fibula fracture with disruption of the distal tibiofibular syndesmosis as well as an associated posterior malleolar fracture with displacement of the fragment anteriorly through the syndesmosis to the ventral aspect of the ankle joint. The patient underwent surgical fixation of the posterior malleolar fracture as well as repair of the syndesmosis with a screw. This report aims to highlight the details of a Maisonneuve fracture with the rarer associated posterior malleolar fracture, and its anterior displacement through the syndesmosis, as well as provide a narrative review of the current literature.

Computer aided diagnosis has gained momentum in the recent past. The advances in deep learning and availability of huge volumes of data along with increased computational capabilities has reshaped the diagnosis and prognosis procedures.
These methods are proven to be relatively less expensive and safer alternatives of the otherwise traditional approaches. This study is focused on efficient diagnosis of three very common diseases: lung cancer, pneumonia and Covid-19 using X-ray images.
Three different deep learning models are designed and developed to perform 4-way classification. Inception V3, Convolutional Neural Networks (CNN) and Long Short Term Memory models (LSTM) are used as building blocks. The performance of these models is evaluated using three publicly available datasets, the first dataset contains images for Lung cancer, second contains images for Covid-19 and third dataset contains images for Pneumonia and normal subjects. Combining three datasets creates a class imbalance problem which is resolved using pre-processing and data augmentation techniques. After data augmentation 1386 subjects are randomly chosen for each class.
It is observed that CNN when combined with LSTM (CNN-LSTM) produces significantly improved results (accuracy of 94.5 %) which is better than CNN and InceptionV3-LSTM. 3,5, and 10 fold cross validation is performed to verify all results calculated using three different classifiersConclusions:This research concludes that a single computer-aided diagnosis system can be developed for diagnosing multiple diseases.

UNASSIGNED: Triage and diagnostic deep learning-based support solutions have started to take hold in everyday emergency radiology practice with the hope of alleviating workflows. Although previous works had proven that artificial intelligence (AI) may increase radiologist and/or emergency physician reading performances, they were restricted to finding, bodypart and/or age subgroups, without evaluating a routine emergency workflow composed of chest and musculoskeletal adult and pediatric cases. We aimed at evaluating a multiple musculoskeletal and chest radiographic findings deep learning-based commercial solution on an adult and pediatric emergency workflow, focusing on discrepancies between emergency and radiology physicians.
UNASSIGNED: This retrospective, monocentric and observational study included 1772 patients who underwent an emergency radiograph between July and October 2020, excluding spine, skull and plain abdomen procedures. Emergency and radiology reports, obtained without AI as part of the clinical workflow, were collected and discordant cases were reviewed to obtain the radiology reference standard. Case-level AI outputs and emergency reports were compared to the reference standard. DeLong and Wald tests were used to compare ROC-AUC and Sensitivity/Specificity, respectively.
UNASSIGNED: Results showed an overall AI ROC-AUC of 0.954 with no difference across age or body part subgroups. Real-life emergency physicians\' sensitivity was 93.7 %, not significantly different to the AI model (P = 0.105), however in 172/1772 (9.7 %) cases misdiagnosed by emergency physicians. In this subset, AI accuracy was 90.1 %.
UNASSIGNED: This study highlighted that multiple findings AI solution for emergency radiographs is efficient and complementary to emergency physicians, and could help reduce misdiagnosis in the absence of immediate radiological expertize.

UNASSIGNED: Skeletal dysplasia\'s cause significant neurological symptoms and disrupt the development of many bones and cartilages in the body. Skeletal dysplasia, although a common presentation in paediatric population, rarely presents in older age group.
UNASSIGNED: This case presents a unique incidental finding of skeletal dysplasia in a fifty-year-old male patient who presented with osteoarthritis. Eventual workup uncloaked the presence of cleidocranial dysplasia and spondyloepiphyseal dysplasia. The patient in this case had both dysplasias at the same time.
UNASSIGNED: Cleidocranial dysplasia and Spondyloepiphyseal dysplasia are two uncommon autosomal dominant dysplasia\'s that are often diagnosed in early life and can have serious consequences, including death. It is critical to diagnose a child early in life. Radiology findings from a thorough skeletal examination aid in the early detection of numerous dysplasia\'s, which helps improving quality of life and allowing for effective treatment.
UNASSIGNED: The novelty of our presented case lies in the rare presentation of CCD and SED occurring concurrently at an older age with accompanying collateral abnormalities usually emerging more commonly in infants. Early diagnosis is thus essential for optimal management.

Femoral neck fractures are one of the most common fractures treated by an Orthopaedic surgeon. Arthroplasty is the recommended management for intracapsular neck of femur fractures in the elderly population owing to the high risk of avascular necrosis of the femoral head following an internal fixation. Elderly patients with intracapsular fractures deemed high risk for anaesthesia (American Society of Anaesthesiology Grade more than 2) are recommended a hip hemiarthroplasty. Routine practice throughout the United Kingdom is to obtain a postoperative check radiograph for all hip hemiarthroplasty patients prior to their discharge from the hospital. This may be done for various reasons like checking the presence of any peri-prosthetic fracture, the position of the components along with the presence of any dislocation. However, it is unclear whether a radiograph is the sole identifier of such complications. Through this study, we aim to analyse whether routine recommendation of post-operative radiographs following hip hemiarthroplasty affects the clinical outcome, and whether it is effective in identifying potential complications before the patients report any signs or symptoms.

BACKGROUND: Point of Care Ultrasound (PoCUS) is a safe, non-invasive tool for identifying distal radius fractures and can potentially be utilised to assist clinicians to reduce displaced fractures. We aim to test whether PoCUS is accurate to identify distal radius fractures and to determine how PoCUS performs as a tool to confirm a successful fracture reduction.
METHODS: A pragmatic prospective observational study was done in adult patients presenting with forearm injuries resulting in Colle\'s type distal radius fractures. Adults who presented to the emergency department (ED) with a suspected distal forearm fracture from August 2018 to July 2019 were conveniently sampled for inclusion into the study when a trained ED ultra-sonographer was available. PoCUS scans over the point of maximal tenderness were done using a high frequency linear transducer (7.5-10 mHz) prior to X-ray. Patients who required a manipulation of the fracture had a second ultrasound scan immediately after the procedure before the second X-ray was ordered. PoCUS scans were compared to X-rays for accuracy in both groups.
RESULTS: Fractures were identified in 44 out of 47 included patients using both PoCUS and X-ray modalities. This showed a sensitivity of 100% (95% CI: 90-100%) and specificity of 100% (95% CI: 31-100%). Fracture manipulation was required in 35 out of 44 patients. The sensitivity and specificity of PoCUS in determining alignment accuracy when compared to X-ray were 100% (95% CI: 83-100%) and 64% (95% CI: 32-88%) respectively. The PPV and NPV were 86% (95% CI: 66-95%) and 100% (95% CI: 56-100%) respectively. Ten out of 44 (23%) patients with distal radius fractures ultimately required an Open Reduction and Internal Fixation (ORIF).
CONCLUSIONS: Our study supports the use of PoCUS for identifying distal radius forearm fractures and may have some value in assisting clinicians to determine post reduction success. We still advocate using standard X-ray radiographs to confirm successful or adequate cortical alignment following a manipulation.