Vacuum phenomenon (VP) is an anatomical entity of potential confusion in the diagnosis and evaluation of joint pathology. Observation of this phenomenon has been demonstrated on basic radiographs, computed tomography, and magnetic resonance imaging. Although VP is most often associated with degenerative joint disease, it is observed with other pathologies. Two problematic scenarios can occur: a false-positive diagnosis of serious pathology instead of benign VP and a false-negative diagnosis of benign VP with a more serious underlying process Despite this potential for confusion, criteria for distinguishing VP from other causes of joint pain and for evaluating a suspected case of VP have not been fully established. We reviewed the literature to determine underlying mechanism, symptomology, associated pathologies, and clinical importance of VP. The formation of VP can be explained by gas solubility, pressure-volume relationships, and human physiology. CT, GRE-MRI, and multipositional views are the best imaging studies to view VP. Although most cases of VP are benign, it can be associated with clinical signs and symptoms. VP outside the spine is an underreported finding on imaging studies. VP should be on the differential diagnosis for joint pain, especially in the elderly. We have proposed criteria for diagnosing VP and generated a basic algorithm for its workup. Underreporting of this phenomenon shows a lack of awareness of VP on the part of physicians. By identifying true anatomic VP, we can prevent harm from suboptimal treatment of patients.

While a vast theoretical literature argues that we live in populist times, the success of populism beyond its electoral dimension is rarely investigated empirically. This paper analyses the development of populism in five Western European countries (Austria, Germany, Netherlands, Switzerland, and the United Kingdom) from the 1970s to the 2010s. First, it measures whether political parties articulate populist discourses more and more often in their election manifestos. Second, the paper tests whether the presence of populism has increased over time in newspaper articles. The results show that populism is not a new phenomenon and that there is no linear increase over the decades. Moreover, while election manifestos are significantly more populist in the 2010s than in previous decades, populism in newspaper articles remains rather stable at a low level, suggesting that the media curb rather than foster populist discourses.

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