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To determine the prevalence of thoracic scoliosis in patients 10-20 years old using radiographs as a screening tool, we studied 783 patients who obtained chest radiographs for nonspinal reasons. We measured thoracic curvature in coronal and sagittal planes; we determined whether age, sex, and sagittal curvature predicted the coronal curvature. The prevalence of scoliosis was 9.3%: 7.0% had curvatures 10°-20°; 1.0% had curvatures 20°-30°; and 1.3% had curvatures of at least 30°. Females (13%) presented larger prevalence of scoliosis than males (4.8%) (P<0.01), also with a larger proportion of larger curvatures. Sex and thoracic kyphosis were independent predictors of the coronal curvature, age was not.

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MRA is an effective method for detection of occlusive lesions in the ECVAs and BAs. Clinically important lesions can be missed by MRA in the ICVA. MRA is more accurate in characterization of occlusive lesions in BAs than in ECVAs or ICVAs.

Background: The management of nondisplaced femoral neck fractures (FNFs) has evolved, with emphasis in radiographic features such as posterior displacement. However, the role of advanced imaging in this scenario is still not well defined. Therefore, our objective is to assess the impact of a computed tomography scan (CT) on interobserver agreement (IA) of fracture classification, posterior tilt measurement, and treatment decisions in nondisplaced FNF in elderly patients. Methods: Eleven patients with a nondisplaced (Garden 1-2) FNF were assessed by six hip surgeons. On a first stage, fracture classification, posterior tilt, and treatment plan (fixation/arthroplasty) were determined only with clinical information and X-rays. On a second stage, a CT was added. The kappa coefficient (k) and intraclass correlation coefficient (ICC) were used to determine IA. Results: IA for Garden classification was only slight in X-rays and with the addition of a CT, with a k ¼ 0.13 (0-0.28) and 0.18 (0.03-0.33), respectively. Conversely, posterior tilt measurement agreement was excellent in both schemes, with an ICC ¼ 0.92 (0.83-0.98) and 0.92 (0.82-0.98). The IA for the proposed treatment was slight with X-rays (k ¼ 0.44; 0.29-0.6), but moderate with the addition of a CT scan (k ¼ 0.67; 0.52-0.82). Changes in surgical decision where made in 14 of 66 evaluations with an OR ¼ 1.4 (0.62-3.2) for choosing an arthroplasty if a CT was used. Conclusion: IA for fracture classification and posterior tilt evaluation in nondisplaced FNF was not altered by the usage of a CT. There is improvement in treatment agreement when a CT scan is added to conventional imaging, with changes in treatment in 21% of cases.

The number of osteoporotic fractures is increasing along with population aging. Most patients with these type of fractures are older than 65 years, with multiple chronic conditions and different degrees of disability. Hip fracture is the most relevant osteoporotic fracture due to its frequency, costs, severity and complications. Multidisciplinary management is of the utmost importance to obtain good therapeutic results. We herein review the management of this fracture. Orthogeriatric joint management should be incorporated in fragility fracture treatment. We contribute with general recommendations for the perioperative management, which can be homologated for the management of older patients with other type of fragility fractures.