Symmetrical sclerosis in both distal femurs of an older woman may be a benign pattern

The edition in brief

A retrospective series of 30 women (mean age 77) describes bilateral sclerotic lesions in the distal femur, mostly lateral, linear, nodular, popcorn-like or mixed, with a reticulonodular pattern within fatty marrow on MRI. One histological specimen from a similar tibial lesion showed fat necrosis with dystrophic calcification. Clinical and laboratory findings did not differ from controls, and the authors propose a distinct benign pattern that may spare unnecessary follow-up or biopsy, though confirmation is needed. A meta-analysis of 14 studies of interventions to raise lung cancer screening participation found that patient navigation combined with shared decision-making (OR 4.34) or with outreach (OR 2.20) increased low-dose CT completion, whereas education alone did not (OR 1.03); certainty was low. A meta-analysis of 13 studies (4,057 patients) found emergency department point-of-care ultrasound in early pregnancy shortened stay by about an hour without a significant difference in missed ectopic pregnancy (RR 1.22, 95% CI 0.39 to 3.87), an interval too wide to exclude harm. Contrast-enhanced ultrasound distinguished focal nodular hyperplasia from hepatocellular adenoma with pooled sensitivity and specificity of about 85% across five studies. The pearl is about finding the old film first.