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Background: Prearthritic hip disorders (PAHD), such as femoroacetabular impingement (FAI), acetabular dysplasia, and acetabular labral tears, are a common cause of pain and dysfunction in adolescent and young adult athletes, and optimal patient-specific treatment has not been defined. Operative management is often recommended, but conservative management may be a reasonable approach for some athletes. Purpose: To identify (1) the relative rate of progression to surgery in self-reported competitive athletes versus nonathletes with PAHD and (2) baseline demographic, pain, and functional differences between athletes who proceeded versus those who did not proceed to surgery within 1 year of evaluation. Study Design: Cohort study; Level of evidence, 3. Methods: An electronic medical record review was performed of middle school, high school, and college patients who were evaluated for PAHD at a single tertiary-care academic medical center between June 22, 2015, and May 1, 2018. Extracted variables included patients’ self-reported athlete status, decision to choose surgery within 1 year of evaluation, and baseline self-reported pain and functional scores on Patient-Reported Outcomes Measurement Information System (PROMIS) domains, the Hip disability and Osteoarthritis Outcome Score (HOOS), and the modified Harris Hip Score. Results: Of 260 eligible patients (289 hips), 203 patients (78%; 227 hips) were athletes. Athletes were no more likely to choose surgery than nonathletes (130/227 hips [57%] vs 36/62 hips [58%]; relative risk [RR], 0.99 [95% CI, 0.78-1.25]). Among athletes, those who proceeded to surgery over conservative care were more likely to be female (81% vs 69%; RR, 1.34 [95% CI, 0.98-1.83]) and had more known imaging abnormalities (FAI: 82% vs 69%, RR, 1.47 [95% CI, 1.09-1.99]; dysplasia: 48% vs 27%, RR, 1.44 [95% CI, 1.16-1.79]; mixed deformity: 30% vs 10%, RR, 2.91 [95% CI, 1.53-5.54]; known labral tear: 84% vs 40%, RR, 2.79 [95% CI, 2.06-3.76]). Athletes who chose surgery also reported worse baseline hip-specific symptoms on all HOOS subscales (mean difference, 10.8-17.7; P < .01 for all). Conclusion: Similar to nonathletes, just over half of athletes with PAHD chose surgical management within 1 year of evaluation. Many competitive athletes with PAHD continued with conservative management and deferred surgery, but more structural hip pathology and worse hip-related baseline physical impairment were associated with the choice to pursue surgery.

more than 120 days after the last ustekinumab treatment were excluded. Finally, 3 patients were considered to have active tuberculosis related to ustekinumab treatment. The duration of ustekinumab treatment before diagnosis of active tuberculosis in these 3 patients was 53, 1046, and 1280 days (Supplemental Table II). There was neither active nor latent tuberculosis within 3 years before first ustekinumab treatment in these 3 patients. Sex-and age-adjusted expected number of active tuberculosis cases from 2803 patients was 3.945; thus, the standardized incidence ratio was 0.76 compared with that in the general population (95% confidence interval 0.59-2.02).This study showed that ustekinumab did not increase the risk of tuberculosis compared with that among the general population in an actual clinical setting in South Korea. Similarly, Hsiao et al 5 reported no active tuberculosis infection in 134 psoriatic patients receiving ustekinumab in Taiwan. Thus, these results suggest that ustekinumab treatment does not require additional tuberculosis monitoring even in areas with high disease burden. Further studies from other regions are needed to validate these results.

Background: Patch testing is the standard to diagnose allergic contact dermatitis (ACD).Objective: This study assessed the value of patch testing for product changes and quality of life in children with ACD. Methods: In this cross-sectional survey, we used a questionnaire to follow up with families of ACD patients about changes since patch testing and counseling preferences. Eligible participants were 18 years or younger during expanded series or personalized patch tests at the Washington University School of Medicine from 2007 to 2020.Results: Of the 43 enrolled participants, most were positive for multiple allergens (63%) and changed personal products after patch testing (71%). Only 26% of the families consistently read product labels before patch testing, compared with 66% after. Patients saw a mean relative reduction of 49% in severity of rash (8.2-4.2 of 10), 46% in interference with activities (5.7-3.1), and 51% in self-consciousness (7.0-3.4) since patch testing. Families gave favorable feedback for counseling on products to avoid (9.4 of 10 average rating of usefulness), product recommendations (8.5 of 10), and chemical names (7.9 of 10).Conclusions: Patch testing can lead to meaningful improvements in quality of life for most children with ACD. Counseling related to positive patch test results should include discussion of specific products to use and avoid.

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