Antibiotic-loaded cement spacers (ALCSs) are essential for treating periprosthetic joint infections (PJIs) by providing mechanical support and local antibiotic delivery. The purpose of this review is to comprehensively examine the various types of spacers utilised in the management of periprosthetic joint infections (PJIs), including both static and articulating variants and to analyse the fundamental principles underlying spacer use, their clinical benefits, the selection and administration of antimicrobial agents, appropriate dosages, and potential adverse effects. Articulating spacers, which allow joint mobility, often yield better outcomes than static ones. Spacer pharmacokinetics are vital for maintaining therapeutic antibiotic levels, influenced by cement porosity, mixing techniques, and the contact area. Antibiotic choice depends on heat stability, solubility, and impact on cement’s mechanical properties. Mechanical properties are crucial, as spacers must withstand physical stresses, with antibiotics potentially affecting these properties. Complications, such as tissue damage and systemic toxicity, are discussed, along with mitigation strategies. Future advancements include surface modifications and novel carriers to enhance biofilm management and infection control.

Atypical femoral fractures (AFFs) are rare but increasingly recognised complications associated with prolonged bisphosphonate therapy. We present the imaging findings of a 64-year-old postmenopausal woman who developed bilateral femoral shaft stress injuries following long-term (4 years) alendronate use. Magnetic resonance imaging demonstrated Grade 3 stress injuries consistent with early incomplete atypical femoral fractures, with lateral cortical involvement and surrounding marrow oedema that preceded fracture completion. Radiographs confirmed an atypical transverse fracture pattern with lateral cortical beaking and minimal comminution. This case highlights the diagnostic value of MRI in detecting early stress-related changes prior to fracture completion, particularly in patients receiving antiresorptive therapy who present with prodromal thigh pain. Recognition of these imaging features is essential for early diagnosis, appropriate modification of osteoporosis treatment, and timely surgical intervention.

" Mass shootings incidents occur with increasing frequency over time. Studying these cases proved that, despite their diversity, several common features could be taken into account in the early detection and possible prevention of certain future cases. Accepting that such incidents may occur anywhere and anytime, societies need to be prepared for their more effective response. Informing citizens about the best way to react to a mass shooting event is considered crucial and essential. The ""Run-Hide-Fight"" guideline/directive seems to be the most appropriate guideline given to the public. Proper training, of both the Suppression Forces and the emergency medical care providers, is considered of utmost importance. The role of the Incident Commander, regarding the incident management, as well as the external bleeding control of the injured people, are factors of paramount importance in trying to mitigate the casualties from such an incident. The alertness of both citizens and organizations/structures may lead to early detection of potential perpetrators and thereby averting a mass shooting incident. To achieve increased survival and a reduced number of casualties from a mass shooting event it is vital proper education be present at all levels. The response to a mass shooting event should be imprinted in an Emergency plan. Such a plan should have been decided and made, by the Security and Suppression Forces, the Healthcare Institutions, and the Public Safety Answering Point. Keywords: mass shooting incident, first responder, active bleeding, tourniquet, Incident Commander"