Patellar Tracking: An Old Problem with New Insights.

Patellofemoral pain and instability are common indications for imaging that are encountered in everyday practice. The authors comprehensively review key aspects of patellofemoral instability pertinent to radiologists that can be seen before the onset of osteoarthritis, highlighting the anatomy, clinical evaluation, diagnostic imaging, and treatment. Regarding the anatomy, the medial patellofemoral ligament (MPFL) is the primary static soft-tissue restraint to lateral patellar displacement and is commonly reconstructed surgically in patients with MPFL dysfunction and patellar instability. Osteoarticular abnormalities that predispose individuals to patellar instability include patellar malalignment, trochlear dysplasia, and tibial tubercle lateralization. Clinically, patients with patellar instability may be divided into two broad groups with imaging findings that sometimes overlap: patients with a history of overt patellar instability after a traumatic event (eg, dislocation, subluxation) and patients without such a history. In terms of imaging, radiography is generally the initial examination of choice, and MRI is the most common cross-sectional examination performed preoperatively. For all imaging techniques, there has been a proliferation of published radiologic measurement methods. The authors summarize the most common validated measurements for patellar malalignment, trochlear dysplasia, and tibial tubercle lateralization. Given that static imaging is inherently limited in the evaluation of patellar motion, dynamic imaging with US, CT, or MRI may be requested by some surgeons. The primary treatment strategy for patellofemoral pain is conservative. Surgical treatment options include MPFL reconstruction with or without osseous corrections such as trochleoplasty and tibial tubercle osteotomy. Postoperative complications evaluated at imaging include patellar fracture, graft failure, graft malposition, and medial patellar subluxation. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.

The effects of elevated carbon dioxide levels on a Vibrio sp. isolated from the deep-sea.

INTRODUCTION: The effect of oceanic CO2 sequestration was examined exposing a deep-sea bacterium identified as Vibrio alginolyticus (9NA) to elevated levels of carbon dioxide and monitoring its growth at 2,750 psi (1,846 m depth). FINDINGS: The wild-type strain of 9NA could not grow in acidified marine broth below a pH of 5. The pH of marine broth did not drop below this level until at least 20.8 mM of CO2 was injected into the medium. 9NA did not grow at this CO2 concentration or higher concentrations (31.2 and 41.6 mM) for at least 72 h. Carbon dioxide at 10.4 mM also inhibited growth, but the bacterium was able to recover and grow. Exposure to CO2 caused the cell to undergo a morphological change and form a dimple-like structure. The membrane was also damaged but with no protein leakage.