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Background Data: Povidone-iodine is very effective broad spectrum antiseptic solution against different types of pathogens including methicillin-resistant Staphylococcus aureus and some strains of Enterococcus faecium based on the antiseptic properties of iodine. Purpose: To evaluate the effect of intraoperative 3.35 % povidone-iodine irrigation in lumbar spine fusion surgeries. Study Design: Retrospective clinical case study. Patients and Methods: 93 spine fusion surgeries in 2016 (Group I) and 112 fusion surgeries in 2017 (Group II). Both groups were retrospectively compared regarding infection rate, fusion rate, and Oswestry Disability Index (ODI) score. Group I had intraoperative saline irrigation and Group II was irrigated with 3.35 % povidone-iodine. Results: There were no reported infections in Group II. Two superficial and two deep wound infections were observed in Group I. Complete wound dehiscence was found in one patient with deep wound infection. The pathogens were methicillin-resistant Staphylococcus aureus in two cases, Klebsiella pneumonia in one case, and combination of methicillin-sensitive Staphylococcus aureus and Staphylococcus epidermidis in the last case. There was insignificant difference between the two groups in fusion rates and with no linear correlation relationship between povidone-iodine soaking time and the fusion rate in Group II. There was significant postoperative ODI improvement in the two groups relative to the preoperative scores with insignificant statistical difference when comparing this improvement of the two groups. Conclusion: Povidone-iodine 3.35% irrigation in lumbar spine fusion surgery is effective in decreasing postoperative infection with no negative influence on the fusion rate or clinical outcome. (2019ESJ177)

Pes anserine bursitis is not an uncommon pathology especially in the context of knee osteoarthritis; however, ruptured pes anserine bursitis is a rare event. Herein, the authors present a case of diving pes anserine bursal rupture in a patient with knee osteoarthritis who developed postero-medial knee tender swelling. In our case, the bursal rupture was contained, and dived posteriorly, resulting in a cystic calf swelling; the original bursa itself was collapsed beneath the pes anserine tendon, giving a taillike appearance, such tail-like appearance could help in accurate localization of swelling origin and make the diagnosis of bursal rupture much easier. The tail-like appearance deep to the pes anserine tendon was found to be a helpful imaging feature when assessing cystic calf swelling; it should be kept in mind when pes anserine bursal rupture is a differential diagnostic consideration, as it could indicate the origin of resultant swelling. Keywords Pes anserine bursitis . Diving pes anserine bursal rupture . Knee osteoarthritis . Cystic calf swelling This article is part of the Topical Collection on Imaging

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