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Ten cases (4%) had combined Masquelet - Ilizarov technique. One hundred seventy five cases (68.9%) had gradual distraction-compression (GDC) technique; while 79 cases (31.1%) had acute shortening and re-lengthening (ASRL) technique. Seventy-two cases (28.3%) had autogenous iliac crest bone graft (ICBG). All cases (100%) had complete clinical and radiological fracture union. All patients completed the follow up that ranged from 24 to 118 months (mean 43.3 ± 23). The results were satisfactory in 212 cases (83.5%) and unsatisfactory in 42 (16.5%) cases due to residual leg length discrepancy, joint stiffness, and persistent pain. DISCUSSION the proposed classification is simple, applicable, recallable and includes most scenarios of reconstructable TCBSTL. The classification provides a basis for communication, description and evaluation of such cases. The algorithm, based on our classification, provides a guideline for management without over/under treatment. PURPOSE There were few reports in the literature about the hidden blood loss (HBL) after intramedullary nail (IMN) fixation for extra-articular tibial fractures. Our purpose was to evaluate the amount of hidden blood loss after intramedullary nail fixation for extra-articular tibial fractures, meanwhile, identified the influential factors causing HBL. METHODS From January 2015 to December 2017, 122 consecutive extra-articular tibial fracture patients fixed with IMN and 96 met all inclusion criteria for the chosen analysis. Preoperative hematocrit (Hct) levels on admission and postoperative Hct levels on the third day after surgery to calculate the amount of HBL. RESULTS The mean HBL was 473.29 ± 102.75 ml after IMN fixation of extra-articular tibial fractures, the multiple regression analysis showed gender, surgical duration, and the diameter of the medullary cavity at the narrowest part of the tibia had an independent influence on HBL. CONCLUSIONS A significant amount of postoperative HBL has occurred after IMN fixation of extra-articular tibial fractures. Surgeons should be aware that more HBL can be developed in patients who have male sex, small medullary cavity, and long-time surgical duration. HBL deserves attention to ensure patients' safety in the perioperative period of IMN fixation for extra-articular tibial fractures. AIM To summarise the features of chest computed tomography (CT) of a series of patients infected with 2019 novel coronavirus (2019-nCov) to speed up recognition and have a better understanding of COVID-19 disease. MATERIALS AND METHODS The clinical information and chest CT images of 93 patients infected with 2019-nCov from multiple centres were reviewed. RESULTS Of the 93 cases, abnormalities in 91 cases were located at the subpleural level, presenting with ground-glass opacity (GGO; n=69, 74.2%) and consolidation (n=56, 60.2%) in multiple lobes. Other CT features included vascular dilatation (n=83, 89.2%), interlobular septal thickening (n=29, 31.2%), bronchodilatation (n=44, 47.3%), the crazy-paving sign (n=34, 36.6%), the sieve-hole sign (n=12, 12.9%), pleural thickening (n=21, 22.6%), and pleural effusion (n=8, 8.6%). Multiple lobe involvement, including the presence of consolidation, the crazy-paving sign, interlobular septal thickening, pleural thickening and pleural effusion, was more common in critical patients with heavy/critical infection (p less then 0.05), whereas the presence of GGO, involvement of one or two lobes, and the halo sign were more common in patients with mild/common-type infections (p less then 0.05). Moreover, older age, higher body temperature, complaints of chest tightness and breathlessness, and lymphopenia was associated with heavy/critical infections. CONCLUSION The CT and clinical appearances of COVID-19 are variable and reflect the severity of COVID-19 to some extent. AIM A national audit reviewing compliance of imaging departments with the Royal College of Radiologist (RCR) standards for cancer multidisciplinary team meetings (MDTMs). MATERIALS AND METHODS The audit consisted of a generic and subspecialty component completed for breast, colorectal, and lung cancer MDTMs. selleckchem RESULTS The study achieved the highest response from a RCR national audit with 145/191 (76%) hospitals responding. Compliance with the RCR standards was suboptimal, particularly relating to MDTM attendance, documentation, and reviewing MDTM imaging. Comprehensive radiology MDTM attendance occurred in 52-65%, a supplementary report denoting staging/treatment plans happened in 15-26%, and late additions were discussed frequently without prior review of imaging (44-77%). Contributing factors maybe 13% of radiologists had no programmed activity for MDTMs in their job plan and a perceived negative impact of increasing MDTM referrals (51%). Adjuncts to improve MDTM workload, such as treatment pathways/algorithms (breast/colorectal 54%) and pro-forma (43-50%), were poorly implemented. Discrepancies with the original imaging report highlighted at MDTMs were well documented (92-94%) and frequently presented at discrepancy meetings (70-81%). Learning from involvement in MDTM was well communicated with 76-84% providing peer feedback. CONCLUSIONS Radiologists are unable to comprehensively attain the RCR MDTM standards on providing and documenting a specialist opinion on the imaging. Increasing referrals to the MDTM appears the predominant factor and differentiating complex cases that benefit from MDTM discussion from those that can be managed via treatment pathways is required. Improved utilisation of pre-MDTMs/pro-forma and information technology in MDTMs may further aid radiologists to provide consistent high-quality contribution towards MDTMs. Crown All rights reserved.AIM To define the role of the T2-weighted axial oblique sequence for the magnetic resonance imaging (MRI) assessment of peroneal tendon pathologies. MATERIALS AND METHODS Two radiologists interpreted 180 ankle MRI examinations using standard sequences alone and then in combination with an axial oblique sequence. The readers indicated how likely a peroneal pathology was present using a five-level confidence scale. Diagnostic confidence, interobserver agreement, and clinical correlation were compared. Changes in diagnosis were recorded. RESULTS For both readers, the diagnostic confidence was significantly higher using the axial oblique sequence for tendinosis and inframalleolar tenosynovitis for both tendons and for peroneus brevis partial and longitudinal split tears (p less then 0.001). For reader 1, the diagnostic confidence was also higher using the axial oblique sequence for peroneus longus partial tears (p=0.007). Changes in diagnosis were seen for tendinosis and tenosynovitis of both tendons and for peroneus brevis partial and longitudinal split tears in 0.
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