Northwestern University

Postpartum pain, a common symptom after a cesarean birth, is influenced by psychosocial factors. This exploratory qualitative study examined patient perspectives on social support and healthcare communication behaviors in the postpartum setting in relation to the pain experience. In-depth, semi-structured, qualitative interviews about postpartum pain experiences were conducted 2-3 days and 2-6 weeks postpartum with individuals who underwent a cesarean birth (2020-2021). Data were analyzed using the constant comparative method. Among 49 postpartum individuals, themes related to social support and healthcare communication were identified in relation to postpartum pain. Participants discussed the impact of non-healthcare social support (e.g., partners, extended family, other children) on postpartum pain, highlighting emotional and practical assistance. Most commonly mentioned were the positive impacts of emotional and logistical support with household activities and childcare on postpartum pain recovery. The second theme covered individuals' views on how healthcare support and communication affected postpartum pain, with themes of both positive and negative experiences. Some participants discussed positive experiences of shared decision-making and responsiveness of the healthcare team, whereas others recounted negative experiences of lack of counseling and poor outpatient communication. Social support and healthcare communication are integral influences on pain recovery after a cesarean birth. These findings highlight the need for interventions to address psychosocial support and healthcare team communication in the immediate postpartum period.

Although most imaging assessments are made qualitatively, quantitative measurements in orthopedic imaging are becoming more important in detecting subtle findings and assessing degrees of abnormality, which can help direct surgical management. In the knee, patellofemoral maltracking is a common cause of anterior pain, particularly in younger patients. Failure to recognize this pathophysiology may result in accelerated chondral loss and osteoarthritis (OA), and the imaging findings may be subtle. As a result, clinicians and radiologists have developed numerous measurements to detect and quantify patellofemoral alignment. Additional entities, such as femorotibial subluxation or angular abnormalities, may only be detected by using standardized measurements and can help detect ligamentous insufficiency or developmental malalignment, which can lead to instability and OA in the medial and lateral femorotibial compartments. Finally, the proper positioning and hardware selection for knee arthroplasty are critical to preventing early hardware failure and postsurgical pain. This review, which focuses on the knee, is the second in a three-part series discussing the appropriate imaging modalities on which to obtain specific lower extremity measurements as well as proper measurement techniques, grouped by pathology. Furthermore, the normal value or range of values according to current literature is reported, along with the significance of abnormal measurements.

To describe a novel optical coherence tomography finding called "scolex sign" in cases of central serous chorioretinopathy. This retrospective multicenter study included patients with central serous chorioretinopathy with serous pigment epithelial detachments (PEDs) greater than 100 µ m, with or without subretinal fluid. Eyes showing a distinct hyperreflective focus on the PED wall (scolex sign) were analyzed. An equal number of age-matched controls with PEDs but without the scolex sign were included. Multimodal imaging data were reviewed. A subgroup analysis based on subretinal fluid status was also performed. Of 291 eyes with large serous PEDs, 52 eyes exhibited the "scolex sign" and were compared with 52 age-matched controls. Baseline characteristics including sex, systemic comorbidities, best-recorded visual acuity and optical coherence tomography parameters were similar in both the groups. However, eyes with the "scolex" sign exhibited a greater number of central PEDs and shorter distance from the foveal center. On follow-up, eyes with the "scolex" sign showed a higher rate of PED flattening and subretinal fluid resolution trended to be higher compared with controls. The "scolex" sign represents a novel, benign optical coherence tomography feature seen in a subset of central serous chorioretinopathy cases. While not associated with poorer outcomes or adverse sequelae, it may reflect ongoing reparative changes, indicating a resolving stage of the disease.