Background/Objectives: Early detection of prostate cancer (PCa) enables timely therapeutic intervention and improved clinical outcomes. Screening strategies are increasingly individualized and now incorporate multiparametric MRI findings, reported using the Prostate Imaging Reporting and Data System (PI-RADS), to refine biopsy decision-making. PROSTest is a novel machine learning (ML)-enhanced, 30-gene mRNA liquid biopsy assay developed to detect PCa from whole blood. In this prospective study (NCT06872619), we evaluated whether PROSTest could function as a pre-biopsy triage tool to inform biopsy decisions while preserving sensitivity for clinically significant prostate cancer (csPCa). Methods: Of 121 men evaluated, 111 (91.7%) completed the full diagnostic work-up—including PSA testing, PROSTest analysis, and PI-RADS assessment—and subsequently underwent image-guided biopsy. Peripheral blood samples for PROSTest were collected prior to biopsy. RNA-stabilized samples underwent RNA isolation followed by reverse transcription and quantitative PCR. Gene expression data were processed using a proprietary machine learning algorithm to generate a continuous range from 0 to 100. A clinically validated cut-off ≥ 50 was applied to produce a binary (positive/negative) result. The diagnostic accuracy of PROSTest was assessed against histology-confirmed prostate cancer. Results: The median age of participants was 69 years (47–83 years) and the median PSA was 7.5 ng/mL (IQR: 5.8–11.4 ng/mL); most patients (104 of 111; 93.7%) had a PI-RADS score of three to five. PCa was diagnosed in 97 men (87.4%) including eight in ISUP Grade Group (GG) 1, 46 in GG2, 33 in GG3, three in GG4 and seven in GG5. PROSTest was positive in 102/111 (91.9%). Among men with biopsy-confirmed PCa, diagnostic accuracy was 99% (93/94). Of the 17 men without histologic evidence of disease, eight (47%) were PROSTest-negative. The overall accuracy was 91% (84.1–95.6%) with an NPV of 89% (51.6–98.4%). Among the nine patients with positive PROSTest but negative biopsy, PI-RADS scores were 4 (n = 6), 3 (n = 1), and 2 (n = 2). Conclusions: PROSTest demonstrated an overall accuracy of 91% (95% CI: 84.1–95.6%) with an NPV of 89%. Among men without a detectable prostate cancer on biopsy, 47% (8/17) were PROSTest-negative. These results suggest that PROSTest may serve as a useful pre-biopsy triage assay.

ABSTRACT Therapeutic effects in acute lung injury (ALI) vary considerably among individuals, presenting a significant clinical challenge in optimizing treatment strategies—particularly with agents such as glucocorticoids. Non‐invasive techniques capable of quantifying pulmonary physiological changes in the lung are essential for evaluating treatment efficacy and elucidating underlying mechanisms. Herein, we investigated the feasibility of hyperpolarized 129 Xe magnetic resonance (MR) for assessing the effects of dexamethasone treatment in a rat model of ALI. Fifteen Wistar rats were randomly assigned to three groups ( n = 5 each): a treatment group with lipopolysaccharide (LPS)‐induced ALI treated with dexamethasone (DEX), an ALI group subjected to the same LPS induction but treated with normal saline, and a control group receiving only normal saline. All rats underwent 129 Xe MR, pulmonary function tests (PFTs), computed tomography (CT), and histological analysis. Quantitative results from 129 Xe MR were analyzed using Kruskal–Wallis tests followed by Conover–Iman multiple comparison tests. Correlations among MRI, PFTs, and CT findings were evaluated. The ratio of 129 Xe signal in red blood cells to pulmonary Membrane (RBC/Mem) was reduced in the ALI group compared with the control group (median, 0.356 [IQR,0.035] vs. 0.607 [IQR,0.086], p < 0.001) and partially recovered in the treatment group ( p < 0.001). Notably, persistent functional impairment in the treatment group was not detected by PFTs or CT imaging. The RBC/Mem correlated well with forced vital capacity (FVC) and mean lung density (MLD) (both p < 0.05). Additionally, hematocrit (Hct) increased in the treatment group compared to the ALI group (Hct: median, 0.242 [IQR, 0.031] vs. 0.216 [IQR, 0.019], p < 0.001). These findings demonstrate the potential of hyperpolarized 129 Xe MR as a non‐invasive and highly sensitive modality for detecting subtle or residual gas‐exchange abnormalities, supporting its further application in interventional studies of acute lung injury.

To determine the value of MRI in men with highly elevated PSA values for the exclusion of clinically significant prostate cancer (csPC). In this retrospective bicenter cohort study, consecutive men with PSA values ≥ 15 ng/mL and multiparametric (mp) MRI were included. We excluded patients with acute prostatitis and patients without histopathology or follow-up. Examinations were evaluated regarding MRI quality, PSAD, and PI-RADS classification. For all patients with subsequent biopsy, PC and csPC detection rates were determined. In a subgroup analysis, patients with and without the presence of csPC were compared regarding clinical and MRI parameters. Finally, 376 patients (median PSA 20 ng/mL) were included. MRI quality was excellent (median PI-QUAL 3). 26% of the patients revealed an MRI with a PI-RADS category 2, 16% were classified as category 3, 12% PI-RADS 4, and 46% showed a PI-RADS 5. A total of 280 patients underwent systematic screening with or without targeted prostate biopsy. Among these, 42% with PSA values ranging from 15 to 116 ng/mL (median 19.5 ng/mL) showed no presence of PC. Overall, csPC detection rates were 94% for PI-RADS 5 and 51% for PI-RADS 4. No csPC were identified in PI-RADS 2, and 8% in PI-RADS 3. Comparative analysis between patients with and without csPC revealed significant differences in age, PSA, PSAD, and PI-RADS (p ≤ 0.05). mpMRI demonstrated excellent performance in the detection of csPC in this high-risk cohort with PSA levels ≥ 15 ng/mL. High-quality MRI helps to exclude csPC in cases with significantly elevated PSA levels to avoid unnecessary prostate biopsies. CRITICAL RELEVANCE STATEMENT: mpMRI demonstrated a high diagnostic accuracy for csPCs in men with PSA ≥ 15 ng/mL, and in cases of non-suspicious MRI findings, it can avoid unnecessary biopsies in these patients at risk. MpMRI demonstrated high diagnostic accuracy in men with PSA values of ≥ 15 ng/mL. MpMRI enables the reliable exclusion of csPC in cases with non-suspicious MRI findings in these patients. In patients with significantly elevated PSA levels, mpMRI provides an effective risk stratification to avoid unnecessary biopsies.

MRI in the incarceration of the gravid uterus: From diagnosis to individualized management.

Clinical, imaging, and immunological features of GFAP astrocytopathy: a systematic review with regional comparison.

Primary leptomeningeal melanomatosis is a rare and aggressive variant of primary central nervous system melanoma. Diagnosis is often challenging due to nonspecific radiologic features. We hereby report the 18F-FDG PET/CT and MRI findings in a case of primary leptomeningeal melanomatosis in a 47-year-old woman with a previously unidentified diastematomyelia. Spinal MRI showed diffuse abnormal signal. 18F-FDG PET/CT showed hypermetabolism most notably in the lumbar and caudal portion of the spinal cord, which was helpful to identify an appropriate site for biopsy.

Characterization of additional MRI findings in patients with Chiari spectrum disorders: focus on Chiari 0-1.5 subtypes.

Medial tibial stress syndrome (MTSS) is among the most prevalent disorders of the lower leg. It is prevalent among athletes, particularly runners. Risk variables encompass female gender, elevated body mass index, and training intensity. Magnetic resonance (MR) imaging has become an extremely accurate technique for identifying bone stress injuries. We report a case of a 38-year-old female exhibiting considerable shin pain, with MRI findings indicative of medial tibial stress syndrome.

This study aimed to identify characteristic contrast-enhanced MRI features of nodular fasciitis that aid in differentiating it from malignant tumors and to evaluate their chronological changes. We analyzed 62 histologically confirmed nodular fasciitis lesions from 61 patients. All patients underwent T2-weighted and post-contrast MRI. Non-enhancing patterns were categorized as follows: type 1 (homogeneous enhancement), type 2 (central non-enhancement), type 3 (heterogeneous non-enhancement), and type 4 (predominantly non-enhancing). Type 4 was subdivided into type 4a (predominantly non-enhancing with minimal peripheral enhancement) and type 4b (completely non-enhancing with perilesional enhancement). MRI findings from 50 malignant tumors served as controls. The initial MRI patterns included type 1 (n = 24, 39%), type 2 (n = 17, 27%), type 3 (n = 9, 15%), and type 4 (n = 12, 19%). Among the 12 type 4 lesions, 8 exhibited type 4b. Three additional lesions evolved into type 4b, totaling 11 (17%) of the 62. A follow-up MRI was performed in 5 type 4b lesions; 4 demonstrated changes to other types, although without a consistent transformation pattern. Type 4b lesions were absent in the malignant control group. In this cohort, type 4b was observed in nodular fasciitis and not in the malignant controls evaluated; specificity beyond this control spectrum remains unknown and requires external validation. The temporal evolution from type 4b to other patterns was variable, potentially explaining the previously reported heterogeneity in MRI findings. Follow-up imaging may help explain the variability in reported MRI appearances.

Pharmacoresistant epilepsy remains a significant challenge in modern neurology, affecting around 30 % of patients who do not respond to medication. Conventional neuroimaging methods often fail to provide sufficient diagnostic information in patients with MRI-negative findings and discordant EEG and MRI data. Optimizing preoperative mapping through noninvasive, high-precision neuroimaging techniques is critical to improving surgical outcomes and patient prognosis. Hybrid PET/MRI imaging with 18 F-FDG offers new possibilities for enhanced preoperative localization in such patients. Objective . To evaluate the diagnostic value and clinical applicability of hybrid PET/ MRI with 18 F-FDG in the preoperative mapping of epileptogenic zones in patients with pharmacoresistant epilepsy, including MRI-negative cases. To perform a quantitative analysis of 18 F-FDG hypometabolism in relation to the type of epilepsy, as well as the frequency and duration of epileptic seizures. Materials and Methods . A screening of 10 healthy volunteers and an evaluation of 130 patients with drug-resistant epilepsy were performed according to the hybrid PET/MRI protocol with 18 F-FDG. Both qualitative and quantitative analyses of hypometabolic brain regions were conducted, with findings correlated to clinical data, video-EEG monitoring results, and MRI findings. This approach enabled integrated assessment of functional and structural abnormalities, provided improved localization of epileptogenic zones, and facilitated the interpretation of metabolic, electrophysiological, and neuroanatomical correlates in the study cohort. Results . The use of interictal brain PET/MRI with 18 F-FDG significantly improved the detection rate of epileptogenic zones compared with standalone epilepsy-protocol MRI. This effect was particularly pronounced in MR-negative cases and in patients with subtle structural abnormalities, which were subsequently recognized upon targeted MRI re-evaluation guided by metabolic findings from PET imaging. In healthy individuals, no significant interhemispheric asymmetry of glucose metabolism was observed; physiologically, temporal regions demonstrate lower SUV values compared with frontal, parietal, and occipital cortices. Across all age groups of patients with pharmacoresistant epilepsy, moderate interhemispheric asymmetry of 18 F-FDG metabolism was identified (asymmetry index range ~ 0.25–0.5). Disease duration and seizure frequency showed no clear linear relationship with focal SUV values. However, in MRI-positive cases with daily seizures, a relative increase in SUV within the epileptogenic focus was noted, likely reflecting postictal metabolic activity without materially affecting overall hemispheric asymmetry. The most pronounced 18 F-FDG hypometabolism was observed in structural focal epilepsy, while higher metabolic activity characterized focal epilepsy of unknown etiology and mixed focal-generalized forms. These findings emphasize that hybrid 18 F-FDG PET/MRI provides an advanced diagnostic advantage through its ability to integrate metabolic and structural data, allowing for improved localization of epileptogenic foci — even in subtle or MRI-negative cases — and thereby enhancing presurgical evaluation and treatment planning. Conclusion . The use of hybrid 18 F-FDG PET/MRI expands the diagnostic capabilities of neuroimaging in patients with focal pharmacoresistant epilepsy. Incorporation of PET/MRI into the presurgical planning workflow has the potential to improve the effectiveness of surgical treatment and enhance patient quality of life.

Central nervous system tuberculosis (CNS-TB) is a rare but highly lethal form of TB with heterogeneous clinical and radiological features. We evaluated objective clinical grading, CSF indices, and MRI findings associated with in-hospital mortality. In this single-center retrospective cohort (2010-2023), all consecutive adults with CNS-TB were included (n = 15). Patients were grouped as survivors (n = 6) and non-survivors (n = 9). We extracted BMRC stage, baseline GCS, symptom-to-presentation and symptom-to-treatment durations, CSF cyto-biochemistry and microbiology (culture/PCR), and a standardized MRI checklist (basal exudates, hydrocephalus, ventriculitis, infarcts, tuberculoma/abscess, cranial nerve enhancement, spinal involvement). Treatment protocols (ATT, dexamethasone indications, neurosurgery) were documented. Results are primarily reported as counts/proportions with exploratory effect sizes. The mortality rate was 60%. Non-survivors were significantly older (57.8 ± 22.8 vs. 29.2 ± 6.9 years; P = 0.029, d = 1.56) and had higher serum AST levels (28.9 ± 6.4 vs. 15.0 ± 2.9 U/L; P = 0.007, d = 2.14). CSF leukocyte count was also significantly elevated in non survivors (P = 0.041, d = 0.95). Cerebral ischemia was present only in non-survivors (56% vs. 0%; P = 0.04, h = 0.98). PCR positivity in non-CSF samples (0% vs. 78%) was significantly associated with mortality (P = 0.007). Other parameters showing moderate to large effect sizes included focal neurological deficits, ventriculitis, and increased CSF opening pressure. Advanced age, elevated AST levels, increased CSF leukocyte count, cerebral ischemia, and extraparenchymal PCR positivity emerged as major predictors of mortality in CNS-TB. These factors may aid early risk stratification and treatment planning. Larger prospective studies are warranted to validate these findings.

Motor neuron diseases (MND) affect the upper and/or lower motor neurons. Radiological diagnostics primarily serve to systematically exclude treatable mimics and support the clinical and electrophysiological diagnosis. The focus is on amyotrophic lateral sclerosis (ALS); supplementary progressive muscular atrophy (PMA, purely lower motor neuron, LMN disease) and spinal muscular atrophy (SMA). Which imaging signs support the diagnosis of ALS, how do electromyography/magnetic resonance imaging (EMG/MRI) fit into the Gold Coast criteria and which other motor neuron diseases are relevant? Overview of clinical criteria (Gold Coast), genetics and typical MRI findings of the brain, spinal cord and musculature. Gold Coast core: progressive motor deterioration, upper motor neuron (UMN) and LMN signs in ≥ 1 region or LMN in ≥ 2regions and exclusion of alternative causes. susceptibility-weighted imaging (SWI) motor band sign as UMN marker; T2/fluid-attenuated inversion recovery (FLAIR) hyperintensities along the corticospinal tract with low sensitivity, moderate specificity; T1 bright tongue as an indication of chronic denervation in bulbar involvement. EMG: detection of subclinical LMN involvement, sometimes limited in UMN-dominant/bulbar courses. PMA: Pure purely LMN symptoms, often continuum to ALS. SMA: Autosomal autosomal recessive (SMN1 deletion). The diagnosis remains primarily clinical; EMG and MRI are supportive. The radiological priority is the exclusion of mimics. The UMN markers increase diagnostic certainty in the context of clinical/EMG findings but do not replace them. Clear findings facilitate classification according to Gold Coast. The PMA and SMA require careful differential diagnostics; characteristic MRI patterns support progression and treatment planning.

To describe and compare clinical characteristics of TMJ involvement in a sample of children with oligoarthritis and seronegative polyarthritis, and to identify factors increasing the odds for different types of TMJ involvements. A retrospective cross-sectional study of 62 children with oligoarthritis or seronegative polyarthritis and associated clinical TMJ involvement at the age of 15 years or younger (range 2-15, mean 7.9, SD 3.6, median 6.7). Clinical TMJ involvement was frequently (35 children, 56.5%) diagnosed early (0 to 12 months) after JIA diagnosis. In five children (8.1%), TMJ involvement was identified prior to diagnosis of JIA. Subjective symptoms were far more infrequently reported (30 children, 48.4%) than abnormal clinical findings (57 children, 91.9%). The most common symptom was pain (28 children, 45.2%) and the most common clinical finding was disturbance of mandibular movements (46 children, 74.2%). Mandibular asymmetry was observed in 18 (29.0%) children. No significant differences in TMJ symptoms and clinical findings were observed between children with oligoarthritis and seronegative polyarthritis. MRI findings were absent in 20 (32.3%) of 62 children. No significant clinical differences between the two JIA groups were observed, likely due to the small sample size. However, important overall characteristics were observed: TMJ involvement frequently presented without any subjective symptoms, and one out of three children had mandibular asymmetry already at the time of diagnosis of TMJ involvement. The findings emphasise the importance of regular examinations of the TMJ in children with JIA in order to prevent facial growth disturbance and malocclusion.

Abstract Goals: Approximately 12-30% of patients with breast cancer undergoing breast-conserving surgery (BCS) require additional surgery due to positive margins, delaying adjuvant therapy and increasing local recurrence risk. Therefore, finding a time- and cost-effective method for intraoperative margin assessment (IMA) is crucial to avoid reoperation. The prospective, multicenter, interventional BrIMA study evaluated the clinical value of intraoperatively addressing positive margins by specimen PET-CT imaging. Methods: Patients received a preoperative intravenous low-dose radiotracer injection (18F-FDG; 0.8 MBq/kg) at the nuclear medicine department and were subsequently transported to the operating room (OR). Immediately after tumor excision, the breast specimen was imaged in the OR using a compact and mobile high-resolution specimen PET-CT imager (AURA10 PET-CT, XEOS, Belgium). The operating surgeon evaluated the 3D PET-CT images during BCS. When positive margins were suspected on imaging, additional breast tissue had to be excised to achieve final negative margins (i.e. oriented cavity shaving). Routine IMA methods (e.g. specimen X-ray, gross pathology, specimen ultrasound, palpation) were permitted only after PET-CT image interpretation was completed. All specimens were then sent to the pathology department for routine histopathological evaluation. The clinical value of intraoperative specimen PET-CT imaging was quantified by the success rate. Surgery was considered successful when all margins of the main specimen were negative, or when positive margins were adequately addressed during BCS; whereas failure was defined as positive margins not addressed during BCS. Histopathology served as the gold standard. Results: The BrIMA study was conducted in six European breast centers. A total of 148 study patients were found eligible for analysis. The final analysis cohort consisted of patients with Invasive Ductal Carcinoma (IDC; n=84), IDC with preoperative aromatase inhibitor therapy (IDC-AI; n=15), IDC with neoadjuvant chemotherapy (NAT; n=13), Invasive Lobular Carcinoma (ILC; n=16), ILC with preoperative aromatase inhibitor therapy (ILC-AI; n=7) and Ductal Carcinoma In Situ (DCIS; n=13). Specimen PET-CT imaging visualized breast tumors across all subtypes, including less 18F-FDG-avid lesions (i.e. ILC, DCIS) and tumors from patient treated with neoadjuvant therapy. Resection margins were evaluable in all tumor specimens (148/148) during BCS. Across all study groups, considering both the invasive and the in situ component, the success rate improved from 76.4% (113/148) without IMA to 81.8% (121/148; p = 0.004) with the routine IMA technique and to 91.9% (136/148; p < 0.001) with specimen PET-CT imaging. For the invasive component of IDC, the success rate in addressing positive margins increased from 83.3% (70/84) without IMA to 86.9% (73/84; p = 0.125) with the hospital’s routine IMA technique and to 95.2% (80/84; p < 0.001) with specimen PET-CT imaging. Fifteen patients (15/148; 10.1%) required reoperation due to final positive margins. Five of these patients had positive margins in the cavity shaves, which were not assessed by specimen PET-CT imaging per study protocol and one patient required reoperation due to postoperative MRI findings. The other nine patients that underwent reoperation could be attributed to the failure of obtaining final negative margins (9/148; 6.1%). For these cases the positive margin of the main tumor specimen was neither addressed by intraoperative specimen PET-CT imaging, nor by the routine IMA methods. Conclusions: Specimen PET-CT imaging provides reliable intraoperative visualization across breast cancer subtypes and outperforms routine IMA methods, yielding clinically relevant improvements in margin assessment during BCS. Citation Format: M. Göker, O. Gentilini, G. Vergauwen, H. Markus, S. Kümmel, G. Cisternino, B. Lambert, X. Kraemer, M. Vanhoeij, V. Vergucht, R. Di Micco. High-resolution specimen PET-CT imaging for intraoperative margin assessment in early-stage breast cancer: the multicenter BrIMA study [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS2-05-28.

Associations between single and combined lumbar MRI findings and low back pain with and without leg pain: a cross-sectional study.

Seizure-like events present a diagnostic challenge for paediatricians, particularly in third-tier cities in southwestern China. Although government initiatives have improved the accuracy of epilepsy diagnosis, substantial disparities persist between southwestern and eastern China. The aims of this study were to investigate clinical characteristics and prognosis of children with seizure-like events in resource-limited cities in southwestern China and to identify factors associated with future epilepsy. This was a retrospective cohort study. We retrospectively reviewed the medical records of 519 children aged 23 days to 13.5 years who experienced seizure-like events. Demographic information, seizure characteristics, electroencephalograph (EEG) and brain MRI were collected. Epilepsy was diagnosed according to the International League Against Epilepsy criteria. Multivariate logistic regression was performed to determine independent predictors of epilepsy. We enrolled 519 children in our hospital. Forty-five (45/263, 17.1%) patients were first diagnosed with seizures. At the first seizure presentation, 263 patients (50.7%) were diagnosed with epilepsy. The aetiology of these patients with epilepsy was more commonly unknown (166/263, 63.2%), followed by a genetic aetiology (65/263, 24.6%). Normal MRI and EEG findings were observed in 218 (42.0%) and 169 (32.6%) children, respectively. Seizure frequency, positive genetic test results, abnormal brain MRI and abnormal video-EEG were predictive of recurrent febrile seizures. Multivariate analysis revealed that high seizure frequency, abnormal video-EEG findings and structural brain abnormalities are key predictors of subsequent epilepsy in children. Although we aimed to identify risk factors applicable to resource-limited areas, we found that only high seizure frequency, abnormal video-EEG findings and structural brain MRI abnormalities independently predicted a subsequent diagnosis of epilepsy. These findings underscore the need for targeted paediatrician training, as well as increased financial investment in resource-limited rural areas to improve hospital infrastructure, in order to help reduce the epilepsy treatment gap.

Abstract Cauda equina syndrome (CES) associated with dural ectasia is a rare manifestation in patients with ankylosing spondylitis (AS). We report a case of a 53-year-old female with a 10-year history of AS who developed CES in the past 1 year. The CT and MRI findings revealed the unique appearances of dural ectasia, multiple ventral dural diverticula, erosion of lumbar vertebral bodies, adhesion of the nerve roots of the cauda equine, and the conus medullaris to the wall of the dural sac. Due to progressive clinical deterioration, surgical decompression was performed via laminoplasty with filum terminale resection to release adhesions involving the conus medullaris and nerve root. Postoperatively, constipation, urinary incontinence, and muscle strength improved. The possible mechanisms of CES associated with chronic AS are discussed.

An 18-year-old woman was admitted to our hospital with altered consciousness and urinary retention. Brain MRI revealed FLAIR hyperintensity along the brainstem surface. Paraneoplastic encephalitis was suspected due to the presence of an ovarian teratoma, and an ovariectomy was performed on the day of admission. Both steroid pulse therapy and high-dose intravenous immunoglobulin therapy were initiated, leading to an improvement in her clinical symptoms and MRI findings. All tested autoantibodies were negative. There have been no reports on the optimal timing of ovariectomy in cases of autoimmune encephalitis associated with ovarian teratoma, except in anti-N-methyl-D-aspartate receptor encephalitis. However, early tumor resection may be desirable for antigen removal, even in cases of autoimmune encephalitis without anti-N-methyl-D-aspartate receptor antibody.

Outcomes of arthroscopic management of bony Bankart (BB) lesions may result in higher reinjury rates, revision surgeries, and return-to-sport outcomes compared with adolescent patients with no bony Bankart (NBB) lesions. Adolescent patients undergoing arthroscopic stabilization (2010 to 2023) with a minimum of 2 years follow-up were categorized into BB and NBB cohorts based on MRI and intraoperative findings. Preinjury glenoid diameter was estimated using a best-fit circle technique. Data collected included demographics, injury details, surgical techniques, and surgical outcomes. Patient-reported outcomes were assessed using single assessment numeric evaluation (SANE), pediatric/adolescent shoulder survey (PASS), and quick Disabilities of the Arm Shoulder and Hand (qDASH) scores. Fifty patients were analyzed (25 BB, 25 NBB), with mean age 16.9±0.9 years (BB) and 16.6±1.0 years (NBB) (P=0.32), and overall mean follow-up 4.2 years. BB was associated with males (P=0.02) and collision mechanisms of injury (P=0.02). BB utilized more suture anchors (6.0±1.2 vs. 4.9±1.4) (P=0.005). Preinjury glenoid diameter was larger in the BB (29.9±2.6 vs. 26.2±2.3mm) (P<0.001). Mean sagittal width of the BB fragment measured 5.7±1.5mm (range: 3 to 10mm) and represented a mean glenoid bone loss of 18.9%±4.5%. Surgery failure rates (32% BB vs. 32% NBB), revision surgery rates (12% BB vs. 4% NBB), and return to sport rates (88% BB vs. 80% NBB) were not significantly different. SANE scores were higher with BB (91.2±9.9 vs. 85.2±12.8) (P=0.03), yet no differences were found in PASS and qDASH outcomes. BB was associated with larger glenoid diameters, male sex, and collision injuries, but outcomes did not appear to vary when compared with NBB shoulders, refuting the hypothesis that bony Bankart shoulders would have poorer short-term to mid-term outcomes over time compared with those with only soft-tissue injury. Recurrent instability and revision surgery rates remain high in this youthful population regardless of the presence of a bony Bankart-associated anterior instability.

Sexual dysfunction (SD), a prevalent yet underreported complication in multiple sclerosis (MS), significantly impacts quality of life. This cross-sectional study at Imam Reza Clinic, Shiraz University of Medical Sciences, evaluated SD prevalence in 80 relapsing-remitting MS (RRMS) patients (65 females and 15 males; mean age 38.7years) compared to 80 demographically matched controls (61 females and 19 males; mean age 39.1years). SD was assessed using the Female Sexual Function Index (FSFI) for females and the International Index of Erectile Function (IIEF) for males, alongside brain-focused MRI to examine morphological changes. Female RRMS patients had significantly lower FSFI scores (mean 21.80, SD 7.13) than controls (mean 27.86, SD 4.83; p < .001). FSFI scores negatively correlated with cerebrospinal fluid volume (r = -0.297, p = .016), disease duration (r = -0.319, p = .010), fatigue (r = -0.412, p = .001), and depression (r = -0.387, p = .002). Male RRMS patients showed lower IIEF scores (mean 64.40, SD 8.77) compared to controls (mean 73.21, SD 2.84; p = .0012), with positive correlations between IIEF scores and insular cortex volume (r = 0.576, p = .025), cerebellar grey matter volume (r = 0.727, p = .002), and total grey matter volume (r = 0.846, p < .001). Multivariate regression identified MRI measurements, disease duration, and fatigue as independent SD predictors (p < .05). The high SD prevalence in RRMS, with distinct sex-specific neuroimaging correlates, highlights the need for routine SD screening and tailored interventions in MS care to improve patient outcomes.