This study demonstrates that there are potentially significant although short-term benefits to be gained from steroid injections into the TMJ. They can lead to pain relief and improved function, certainly in the first 1 to 3 months post-injection. Steroid injections are a low-risk procedure and are helpful in delaying or avoiding the need for surgery.

We report a single-blinded randomized controlled trial comparing acupuncture to sham (non-penetrating) needling for relief of symptoms of basal thumb joint arthritis. Seventy acupuncture naive patients with basal thumb joint arthritis were randomized to receive true acupuncture or sham needling with 35 patients in each arm. Blinded baseline and post-treatment assessments included visual analogue pain scores for different grips and movement. Function was assessed using the Nelson questionnaire. Both groups showed statistically and clinically significant improvements in pain at week one post-treatment compared with baseline, but there was no difference between the treatment groups. The pain relief was comparable with published data for some standard treatments. Acupuncture did not perform better than sham needling in this study, indicating that pain relief may have been achieved through non-specific mechanisms. Level of evidence: I

There is only a small body of evidence currently published on this topic. The evidence published so far concludes that elastic intramedullary nailing represents an effective and reliable method to treat an unstable fracture of the tibial diaphysis in the paediatric patient, where conservative management is not appropriate.

Laparoscopic approach is safe for advanced appendicitis in children. The outcomes are comparable in both study groups.

Intra-arterial corticosteroid injection at the wrist can have devastating consequences. Anatomic arterial variation of the hand can lead to atypical presentation. A careful history and examination, with appropriate investigations, can lead to an accurate diagnosis in such difficult cases.