Background Headless compression screws have been used for arthrodesis of the distal interphalangeal joint with good clinical results. However, some distal phalanges are too small, thus precluding their use, or increasing complication rates. Methods In order to validate our digital measurements, radiographs of five cadaveric hands were obtained. The distal phalanges of these fingers were measured using our institution's digital radiograph software. The cadavers were then dissected, and the actual phalanges were measured to confirm the accuracy of the digital measurements; 200 consecutive hand radiographs were then measured to obtain average width and heights of the narrowest measurements of the distal phalanx of each finger. Subgroup analysis of each finger for age and gender was completed. Results and Conclusions Females were routinely smaller than their male counterparts. No age-related differences were seen. A substantial number of fingers were found to be too small to allow for use of headless compression screws; 42 % of small finger distal phalanges are too small to accommodate 2.8-mm threads, and that number increases to 81 % with 3.2-mm threads and 97 % with 3.5-mm threads. Few distal phalanges, regardless of which finger, are large enough to accommodate 3.5-mm-diameter threads; 22% of female ring finger distal phalanges are smaller than 2.8 mm, and 66 % of ring fingers are smaller than 3.2 mm. Based on our measurements, a surprising number of distal phalanges are smaller than the trailing thread diameter of commonly commercially available headless screws. Care must be taken in selecting implants for distal interphalangeal (DIP) fusion.

The ability to reliably measure and calculate the degree of transverse plane rotation by radiographs in cerebral palsy patients with spino-pelvic deformity by the method described by Lucas et al. is poor, likely because of difficulty in consistently identify pelvic landmarks.

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e16593 Background: Bladder cancer afflicts over 700,000 patients in the US and is one of the most expensive cancers to treat. Given a recurrence rate of up to 70%, regular often prolonged surveillance is required. In addition to urine based tests, current standard evaluation includes cystoscopy which is burdensome for patients and physicians; there has long been a need for a reliable non-invasive alternative diagnostic tool. While there is a wealth of literature on urinary biomarkers, no single biomarker has demonstrated consistent high sensitivity and specificity. Methods: The CarePoint Assay, a point-of-care (POC) tool, can perform multiple biomarker tests simultaneously. In this study, urine was collected from patients undergoing urologic evaluation for hematuria from three separate institutions. The urine was sent for central evaluation and the CarePoint Assay was used to detect the bladder cancer biomarker BTA. POC results were then compared to results from a highly sensitive 6-hour ELISA. The accuracy of distinguishing high-grade tumors, low-grade tumors and no tumor present were compared between the two methods. Results: The CarePoint Assay demonstrated excellent correlation with the ELISA in detecting biomarker levels and distinguishing high-grade tumors as well as a superior specificity (88% versus 77%) for ELISA, sensitivity (52% vs. 72%) for ELISA and a limit of detection of 2.55 ng/mL (16 picomolar). Conclusions: With this high performance, the CarePoint Assay has the ability to detect and multiplex multiple other bladder cancer biomarkers with higher sensitivity and specificity. Additional biomarker analysis using the CarePoint Assay may yield the medically desired higher levels of sensitivity and specificity for a non-invasive point-of-care bladder cancer test, ultimately limiting the patient burden of bladder cancer surveillance.