Notes

[POCUS (Point-of-Care Ultrasonography) throughout interior standard medicine: applications range and also training].
treatment or tendon healing, residual subscapularis muscle injury was seen, which may have long-term implications.
Patients frequently undergo interventions before shoulder arthroplasty, including injections and arthroscopy. Although the potential impact of injections on postoperative outcomes such as infection has been well studied, it is less clear whether prior arthroscopy has an impact on infection rates after shoulder arthroplasty. The purpose of this study was to determine whether prior ipsilateral shoulder arthroscopy is associated with an increased risk of postoperative infection after shoulder arthroplasty.

Patients who underwent shoulder arthroplasty, including hemiarthroplasty, total shoulder arthroplasty, or reverse shoulder arthroplasty with a minimum of 1-year preoperative database exposure, were queried using Current Procedural Terminology codes from 2 large insurance databases, including both private-payer (Humana, 2008-2017) and Medicare (2006-2014) data. Patients with procedures for infection, fractures, or without laterality data were excluded. Those who underwent ipsilateral shoulder arthroscopy wir arthroscopy performed within 2 years before shoulder arthroplasty is associated with a higher infection rate in the first year after shoulder arthroplasty.
Shoulder arthroscopy performed within 2 years before shoulder arthroplasty is associated with a higher infection rate in the first year after shoulder arthroplasty.
In reverse shoulder arthroplasty, Inferior tilt was originally promoted to decrease rates of baseplate failure. However, the literature is conflicting regarding the effect of tilt on scapular neck impingement, which has been associated with an increased risk of notching, increased risk of impingement-related instability, and decreased range of motion. We hypothesized that inferior tilt of -10° would lead to increased medialization and increased scapular neck impingement compared with 0° of tilt.

Twenty patients without glenoid bone loss undergoing reverse shoulder arthroplasty (RSA) at a single institution underwent computed tomography scans of the entire scapula and proximal humerus for preoperative planning. For each patient, we digitally implanted a 25-mm glenoid baseplate flush with the inferior rim of the glenoid. We then simulated impingement-free range of motion with 16 different implant configurations glenoid tilt (0° vs. -10°), baseplate lateralization (0 mm vs. ULK-101 +6 mm), glenosphere size (36 mm vst; .001), glenoid tilt (P = .001), inclination (P < .001), and RSA angle (P = .023 for ERS and P = .025 for ADD).

Relative to 0° of tilt of the baseplate, inferior tilt of -10° was associated with increased scapular neck impingement in ERS and ADD, likely a result of the increased medialization necessary to seat an inferiorly tilted implant, which shortens the scapular neck and brings the humerus closer to the scapula. This scapular neck impingement increases the risk of notching and impingement-related instability.
Relative to 0° of tilt of the baseplate, inferior tilt of -10° was associated with increased scapular neck impingement in ERS and ADD, likely a result of the increased medialization necessary to seat an inferiorly tilted implant, which shortens the scapular neck and brings the humerus closer to the scapula. This scapular neck impingement increases the risk of notching and impingement-related instability.
Ulnar collateral ligament (UCL) injuries are common in baseball pitchers. The purpose of this study was to evaluate changes to medial elbow joint laxity under valgus stress, as well as under valgus stress with flexor digitorum superficialis (FDS) contraction, and its ability to predict rehabilitation outcomes.

Sixty-one UCL injuries were diagnosed. All patients were high school students who initially received rehabilitation treatment. Rates of return to play and return to the same level of play or higher (RTSP) were calculated and correlated with joint gapping under the following conditions elbow gravity valgus stress and intra-articular ring-down artifact (RDA) at rest, elbow gravity valgus stress, and elbow gravity valgus stress with maximum FDS contraction.

The overall RTSP rate in patients receiving nonoperative treatment was 83.6% (51 of 61 patients). The RDA at rest significantly differed between the RTSP and non-RTSP groups, with an odds ratio of 17.5. This result indicated that the RDA could be a predictor of rehabilitation outcomes. Moreover, there were significant differences in the RDA under gravity valgus stress conditions with FDS contraction between the 2 groups, with an odds ratio of 98.0. Multivariate logistic regression analysis identified 1 variable (RDA under valgus stress with FDS contraction) as the most significant predictive factor for successful treatment of UCL elbow injury.

UCL injuries in high school baseball players can be successfully treated nonoperatively in most cases. Stress ultrasound with FDS muscle contraction can help predict the potential for RTSP.
UCL injuries in high school baseball players can be successfully treated nonoperatively in most cases. Stress ultrasound with FDS muscle contraction can help predict the potential for RTSP.A 2-year-old male neutered mixed breed dog was referred for evaluation of left-sided unilateral epistaxis and mucoid discharge following adoption from Mexico 2 months prior to presentation. Computed tomography (CT) showed soft tissue that filled the entirety of the left nasal passage with mild turbinate loss. Subsequent rhinoscopy revealed multifocal patches of discrete, white, wispy, vascularized abnormal tissue in the left nasal cavity. Cytology and histopathology procured with rhinoscopic-guidance were suspicious for transmissible venereal tumor (TVT). Confirmation of a TVT diagnosis was made with polymerase chain reaction for the long interspersed element inserted upstream of the c-myc gene. The dog was treated with 4 cycles of vincristine (0.5 mg/m2, IV, once every 7 days) with complete and sustained resolution of clinical signs shortly after the third cycle. Nasal TVT in dogs is an uncommon presentation of a neoplasm that primarily results in genital or oral lesions. There is a void in the veterinary literature regarding the rhinoscopic appearance, as well as limited clinical descriptions of nasal TVT.
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