Cobb angle measurement with a conventional convex echography probe and a smartphone.

BACKGROUND CONTEXT: Serial X-rays are needed during the follow-up of adolescent idiopathic scoliosis. They are done every 6 or 3 months in cases of high risk of progression. Thanks to the advances in ultrasound techniques, deformity measurement systems free from ionizing radiations have been validated, although spinal surgeons did not use them routinely due to the need of special software. OBJECTIVE: The aim of our work is to assess the reproducibility and correlation of an ultrasound measuring system based on the positioning of the transverse processes. STUDY DESIGN: Prospective, single center, randomized, triple blinded. METHODS: Two independent researchers trained in ultrasound examined the spinal deformities of 31 children. The measurements were compared against those performed with an X-ray by three scoliosis expert surgeons. Statistics were performed by an independent researcher. Parametric methods were used. RESULTS: We found a 95% [(0.91-0.97) p < 2.2e-16] correlation between the degree of scoliosis measured with the proposed ultrasound system and the 30 cm × 90 cm X-rays in standing position. There was an intra-observer reliability of 97% [r-squared = 0.97; CI 95% (0.95-0.98) p < 2.2e-16] and an inter-observer reliability of 95% [r-squared = 0.95; CI 95% (0.90-0.97) p < 2.2e-16]. CONCLUSIONS: An approximation of the Cobb angle measure is possible with ultrasound by using the transverse processes as reference. This is a very rapid and simple system for assessing the principal spinal deformity measure in young people, although it does not allow estimating the associated axial or sagittal rotation. These slides can be retrieved under Electronic Supplementary Material.

The proportion and characteristics of adolescents who return for anonymous HIV test results.

BACKGROUND: The proportion of adolescents who return for HIV test results varies widely, and knowledge of what characteristics affect their return is limited. GOAL: To quantify the proportion of adolescents who return for results of anonymous HIV tests, and to identify the characteristics that predict their return. STUDY DESIGN: This retrospective study evaluated 285 adolescents consenting to anonymous HIV tests in an urban clinic that provides medical services free of charge without eligibility requirements to a mostly working, uninsured population. RESULTS: Of the adolescents studied, 42% returned for test results. Three characteristics independently predicted their return: (1) coming to the clinic only for HIV testing, (2) having private health insurance, and (3) engaging in unprotected sex while using drugs or alcohol. CONCLUSIONS: Except for having unprotected sex while using drugs or alcohol, the characteristics that placed adolescents at risk for HIV infection did not predict their return for test results. Given the low return rate for anonymous testing in this setting, confidential testing, which permits follow-up evaluation of those failing to return for test results, should be considered.

Breakage of Knowles pins used for femoral neck fractures.

We report the breakage of multiple Knowles pins in two patients with fractures of the femoral neck. The break occurred at the junction of the threaded and smooth sections of the pins before consolidation of the fracture.