Lend Me a Hand: A Value-Based Care Case Study on Pan Plexopathy of Unknown Origin

Increased Surveillance or Increased Scrutiny: Curbing Inappropriate Screening of Endometrial Cancer in Transgender Men

Objective: The transgender male body is often considered a "black box" by even the most senior of attending physicians. Because of the stigma and fear associated with the utilization of Hormone Replacement Therapy (HRT) and the lack of clinical knowledge surrounding the subject, many transgender men will experience unnecessary testing for endometrial cancers. Materials and methods: This narrative review looked through publicly available PubMed and GoogleScholar articles on the topic of the use of pelvic ultrasounds in gynecological screening in transgendered males. 18,000 articles were filtered by relevance, date, clarity of the topic, and clinical recommendations. Of these articles 37 were included for discussion. Results: Of these 18,000 articles, only 37 were included for discussion. The resulting table, diagnostic tree, and discussion section are included within. Conclusion: Herein, the authors discuss the current understanding of the role of imaging in the diagnosis and treatment of gynecological cancers in transgendered men and how unnecessary imaging studies can be curbed for the benefit of the patient and the medical system at large.

Evidence-based imaging for the management of lower back pain in the emergency department: A narrative review

Patients often present to the emergency department with nonspecific complaints of lumbar back pain. Because of the nature of the emergency department, the lack of knowledge or time on the part of providers, and the high levels of quick decision making, unnecessary imaging studies are often ordered to provide care for the patient’s emotional and perceived physical needs. This narrative review will present a hypothetical typical standardized case of a patient presenting with lower back pain, examine the current evidence and recommendations from the major ruling bodies in internal medicine, neurology, neurosurgery, and radiology, evaluate the major statements released by the Choosing Wisely campaign, and finally, present a new diagnostic decision tree for the management of lumbar back pain.