Background: Although corticosteroid injections are an effective treatment for musculoskeletal pathologies, they may not be suitable for all patients. The purpose of this systematic review was to compare clinical outcomes between patients who received NSAID and corticosteroid injections for various orthopedic conditions. Methods: Medline, Embase, Web of Science, and Cochrane Central Register of Controlled Trials were searched, and meta-analyses were performed using a random-effects model for outcomes presented in three or more studies. Other studies were qualitatively analyzed. Results: A total of 28 articles with 2113 patients were included. A meta-analysis of five studies in patients with shoulder impingement syndrome demonstrated that there was no significant difference in the pain visual analogue scale (VAS) between subacromial NSAID injections and corticosteroid injections at 1 month [weighted mean difference (WMD) −0.244; 95% CI, −1.232 to 0.745; I², 94.5%]. For patients with knee osteoarthritis, a meta-analysis of three studies demonstrated that there was no significant difference between intraarticular NSAID injections and corticosteroid injections in pain VAS at 1 month (WMD 0.754; 95% CI, −0.413 to 1.921; I², 90.2%) and 3 months (WMD−0.089; 95% CI, −0.345 to 0.166; I², 0%). A review of the studies assessing pain outcomes for hip osteoarthritis, adhesive capsulitis, and plantar fasciitis showed no significant differences between the NSAID and corticosteroid groups. Conclusion: NSAID injections may be safe and effective alternatives to steroid injections, especially in shoulder impingement syndrome and knee osteoarthritis.

Background: Standardized registries, such as the International Classification of Diseases (ICD) codes, are commonly built using administrative codes assigned to patient encounters. However, patients with fall injury are often coded using subsequent injury codes, such as hip fractures. This necessitates manual screening to ensure the accuracy of data registries. Objective: This study aimed to automate the extraction of fall incidents and mechanisms using natural language processing (NLP) and compare this approach with the ICD method. Methods: Clinical notes for patients with fall-induced hip fractures were retrospectively reviewed by medical experts. Fall incidences were detected, annotated, and classified among patients who had a fall-induced hip fracture (case group). The control group included patients with hip fractures without any evidence of falls. NLP models were developed using the annotated notes of the study groups to fulfill two separate tasks: fall occurrence detection and fall mechanism classification. The performances of the models were compared using accuracy, sensitivity, specificity, positive predictive value, negative predictive value, F₁-score, and area under the receiver operating characteristic curve. Results: A total of 1769 clinical notes were included in the final analysis for the fall occurrence task, and 783 clinical notes were analyzed for the fall mechanism classification task. The highest F₁-score using NLP for fall occurrence was 0.97 (specificity=0.96; sensitivity=0.97), and for fall mechanism classification was 0.61 (specificity=0.56; sensitivity=0.62). Natural language processing could detect up to 98% of the fall occurrences and 65% of the fall mechanisms accurately, compared to 26% and 12%, respectively, by ICD codes. Conclusions: Our findings showed promising performance with higher accuracy of NLP algorithms compared to the conventional method for detecting fall occurrence and mechanism in developing disease registries using clinical notes. Our approach can be introduced to other registries that are based on large data and are in need of accurate annotation and classification.

Objective: Arch support insoles are among the first-line conservative treatments for patients with metatarsalgia. This study aims to exam ine the clinical effect, along with the associated radiologic changes in foot alignment, among metatarsalgia patients with and without the use of arch support insoles. Methods: In this clinical trial, 14 patients with metatarsalgia aged 18 to 65 years were recruited. Pain intensity was obtained at the first visit and after 4, 8, and 12 weeks. All participants underwent bilateral weight-bearing computed tomography (WBCT) and weight-bearing (WB) radiographs of their feet while standing barefoot and on non-custom-made insoles. Several linear and angular radiological measurements were conducted and compared between the barefoot and insole conditions. Interobserver reliability was calculated (intraclass correlation coefficient [ICC]), and the groups were compared using P < .05 as the statistical significance threshold. Results: A total of 14 patients, consisting of 6 females and 8 males, participated in the study. Patient-Reported Outcomes Measurement Information System Pain Intensity scores showed significant improvement starting from the 8th week (P = .04). Weight-bearing radio graphic measurements showed significant decreases in the M2-M3 and M2-M5 tangent angles (P = .04 and .03, respectively). Similarly, the M4-M5 intermetatarsal angle decreased when wearing insoles (P = .01). There were no significant changes in the WBCT measurements. Conclusion: Arch support insoles significantly improved pain in patients with metatarsalgia. This symptomatic relief coincides with immediate radiologic changes, mainly in the forefoot area. Future prospective studies with larger populations are suggested to investigate the effects of these insoles on metatarsalgia with various foot types. Cite this article as: Taseh A, Ghandour S, Karaismailoglu B, Toy K, Ashkani-Esfahani S, Landsman A. The effect of arch supports on foot alignment in patients with metatarsalgia based on weight-bearing computed tomography and radiographic parameters. Acta Orthop Traumatol Turc., 2025;59(6):374-378.