Objective: To synthesize magnetic resonance imaging (MRI) features and their reported diagnostic performance that differentiate benign from malignant soft-tissue tumors in alignment with the 2020 World Health Organization classification. Materials and methods: A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials were searched through July 2024. Eligible studies reported MRI feature frequencies or diagnostic accuracy for common soft-tissue tumor subtypes. Reviews, case reports, duplicates, non-English publications, and studies outside the scope were excluded. Quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Results: Seventy-six studies met inclusion criteria. In lipomatous tumors, homogeneous fat signal and thin septa supported lipoma, whereas thick or nodular septa and enhancement favored atypical or well-differentiated liposarcoma. Myxofibrosarcoma often demonstrated an infiltrative fascial “tail.” Vascular lesions included angioleiomyoma with a reticular T2 pattern and glomus tumor with marked T2 hyperintensity and avid enhancement. In peripheral nerve sheath tumors, lower apparent diffusion coefficient values and peritumoral edema favored malignancy. Heterogeneity in imaging protocols precluded meta-analysis; results were summarized descriptively by subtype. Conclusion: Consolidated MRI patterns—such as septal morphology in lipomatous tumors, the fascial tail in myxofibrosarcoma, characteristic T2 patterns in vascular lesions, and diffusion and edema cues in nerve sheath tumors—support differentiation of benign and malignant entities, enhance reader confidence, and inform biopsy and management. Standardized prospective studies are needed to validate these thresholds and improve generalizability.

Pudendal neuropathy is a complex and often treatment-resistant cause of chronic pelvic pain. This study evaluated the efficacy of CT-guided pulsed radiofrequency ablation (pRFA) compared to traditional perineural steroid injections in patients with refractory pudendal neuralgia. Using a retrospective cross-sectional design, 49 patients were assessed for pain relief duration, quality of life, and analgesic use over six months. The average pain relief duration following pRFA was 9.48 ± 9.52 weeks, significantly longer than that of the first (3.98 ± 3.56 weeks) and most recent steroid in-jections (3.32 ± 3.21 weeks; p < 0.0001 for both). Quality of life scores improved significantly through three months post-procedure, and analgesic use decreased during this time. No significant correlation was found between symptom duration and treatment effectiveness. These findings suggest that pRFA provides longer-lasting pain relief and improved outcomes, supporting its role as a minimally invasive and effective treatment option for managing chronic pudendal neuropathy.

Introduction: This study evaluated whether major depressive disorder (MDD), a common comorbidity affecting outcomes after total hip arthroplasty (THA), is independently associated with new-onset psychiatric and somatic morbidity. Methods: Adults undergoing primary THA (2015-2024) were identified from a multi-institutional database, excluding patients with prior hip pathology or psychiatric diagnoses other than MDD. Propensity score-matched cohorts were compared at 90 days and 1 year using odds ratios (OR) with 95% confidence intervals (CI). Results: After exclusions, 5,864 patients with MDD and 144,640 control subjects were identified, yielding 3,412 matched pairs. P < 0.001 unless otherwise noted. MDD was associated with significantly higher odds of new-onset psychiatric disorders at 90 days and 1 year, including generalized anxiety disorder (OR _90d , 22.48: 95% CI, 14.6-34.5; OR _1yr , 16.53: 95% CI, 12.0-22.8), adjustment disorder (OR _90d , 5.81: 95% CI, 3.9-8.6; OR _1yr , 5.40: 95% CI, 3.9-7.4), posttraumatic stress disorder (OR _90d , 4.14: 95% CI, 2.8-6.1; OR _1yr , 7.33: 95%, CI 5.4-9.9), schizophrenia (OR _90d , 2.21: 95% CI, 1.1-4.6: P = 0.03; OR _1yr , 2.22: 95% CI, 1.3-3.8: P = 0.002), alcohol use disorder (OR _90d , 3.73: 95% CI, 2.6-5.4; OR _1yr , 2.61: 95% CI, 1.9-3.6), opioid use disorder (OR _90d , 2.31: 95% CI, 1.2-4.3: P = 0.02; OR _1yr , 2.69: 95% CI, 1.7-4.2), dementia (OR _90d , 12.24: 95% CI, 8.2-18.3; OR _1yr , 9.27: 95% CI, 6.6-13.0), and suicide (OR _1yr , 6.71: 95% CI, 3.7-12.0). Somatic risks included mortality (OR _90d , 2.26: 95% CI, 1.1-4.5: P = 0.02; OR _1yr , 1.96: 95% CI, 1.4-2.7), chest pain (OR _90d , 1.74: 95% CI, 1.3-2.3; OR _1yr , 1.25: 95% CI, 1.1-1.5, P = 0.007), shortness of breath (OR _90d , 1.28: 95% CI, 1.0-1.7: P = 0.0498; OR _1yr , 1.28: 95% CI, 1.1-1.5, P = 0.002), dizziness (OR _1yr , 1.49: 95% CI, 1.2-1.8), and postoperative emergency department visits (OR _1yr , 1.27: 95% CI, 1.1-1.5). Conclusion: In patients with isolated MDD, the condition independently increased psychiatric, cognitive, somatic, and mortality risks after THA.

Heart failure is a known risk factor for complications after arthroplasty, yet few studies separate heart failure with reduced ejection fraction (HFrEF; left ventricular ejection fraction ≤40%) from heart failure with preserved ejection fraction (HFpEF; left ventricular ejection fraction ≥50%). We evaluated whether heart failure subtype influences postoperative outcomes after total hip arthroplasty (THA) and total knee arthroplasty (TKA). Using the TriNetX Network, we conducted a retrospective cohort study of adults with HFrEF or HFpEF undergoing elective primary THA or TKA (2004-2024). Propensity score matching (1:1) balanced demographics, comorbidities, medications, and laboratory values. Seven complications were assessed at 90 days and 1 year. In the THA cohort (560 matched pairs), HFrEF was associated with higher odds of acute kidney failure (OR_1year = 1.63, P < .01), myocardial infarction (OR_90days = 1.66, P = .012), stroke (OR_90days = 3.11, P < .01), atrial fibrillation (OR_90days = 1.56, P < .01), and mortality (OR_1year = 1.54, P = .044); cardiac arrest and sepsis did not differ. In the TKA cohort (950 matched pairs), HFrEF was associated with higher odds of acute kidney failure (OR_1year = 1.45, P < .01), myocardial infarction (OR_1year = 1.93, P < .01), atrial fibrillation (OR_90days = 1.56, P < .01), mortality (OR_1year = 1.85, P < .01), and cardiac arrest (OR_1year = 2.37, P = .011); stroke and sepsis did not differ. HFrEF confers higher risk than HFpEF after THA and TKA, supporting the need for HFrEF-specific perioperative management to improve outcomes.