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Objectives Ultrasound (US)-guided injections using corticosteroids or platelet-rich plasma into the knee joint are commonly used for conservative treatment of knee pathology. Practitioner skill acquisition can be challenging due to expensive simulation models and desire to limit practice on live patients. We sought to create an inexpensive, accurate educational prototype for intra-articular knee injections. Methods Two polyvinyl chloride (PVC) pipes were used for the skeletal infrastructure with a detergent pod placed in between the PVC pipes to replicate the joint space. Layers of undercooked bacon simulated the hyperechoic medial collateral ligament and hypoechoic subcutaneous tissue. The total model cost was $6.88. Results Our PVC model simulated anatomical landmarks and was validated through comparison to standardized educational US training videos. The model was successfully recreated 10 times. Furthermore, the PVC model was able to facilitate intra-articular knee injections by penetrating through the superficial structures of the model and injecting into the detergent pod. The model was used to facilitate injections under US guidance with 24 different medical student practitioners across 4 different educational sessions. We further validated our model with US experts. Conclusions Our knee model was successful in replicating medial, intra-articular knee injections under US guidance. It provided accurate injection practice as it simulated realistic bony landmarks and soft tissue. Because our model is inexpensive and easy to make, many more learners in the medical field can now safely and easily practice this procedure.

ObjectivesUltrasound‐guided injections are used to treat common shoulder pathologies and have been shown to be more accurate and effective than traditional landmark‐guided procedures. Currently, there exists no inexpensive shoulder model that accurately simulates the anatomical structures of the shoulder while also facilitating glenohumeral joint (GHJ) injection. Our model is an alternative to the traditional bedside training and provides a low‐risk training environment.MethodsWe created this model from easily accessible materials. Polyvinyl chloride pipe was used to create the skeletal infrastructure pectoral girdle. A detergent pod was used to represent the GHJ space. Steaks were used to simulate the infraspinatus and deltoid muscles, with meat glue as a fascial layer between the two simulated muscles. Total cost of materials for the model was $19.71.ResultsOur model successfully replicates known anatomical features of the GHJ. Additionally, the model facilitates injection into a GHJ space, representing a GHJ injection. Our model was replicated to train medical student practitioners during five different educational sessions. The model was validated through comparison to standardized educational ultrasound training videos. It was further validated by ultrasound experts.ConclusionsThe shoulder model we created is effective in simulating GHJ injections under ultrasound guidance. It simulates realistic muscle and bony landmarks both for ultrasound imaging and injection feel. Importantly, it is inexpensive and easy to replicate allowing more access to medical practitioners and students to be educated on the procedure.

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BackgroundAlzheimer’s disease (AD) is sometimes referred to as Type 3 diabetes. While it is very likely that insulin dysregulation and resistance participate in the etiology of AD pathologies, little is known about the possible correlation between diabetes and the progression of cognitive decline in AD patients. Previous studies have shown an increased risk of developing AD in patients with type 2 diabetes mellitus (T2DM). The specific aim of our study was to determine whether differences exist in cognitive decline experienced by AD subjects with and without T2DM co‐morbidity.MethodAll cognitive performance data and the presence or absence of T2DM co‐morbidity in AD patients used in the present report were derived from the Uniform Data Set (UDS) of the database maintained by the National Alzheimer’s Coordinating Center (NACC), USA. The scanning of the UDS database identified 3055 participants with AD who had more than one epoch completed. The dataset culled clinically‐diagnosed AD patients who were assessed for diabetes type in form A5 or D2 during at least one visit. These patients were divided into two groups dependent upon the presence of a diagnosis of T2DM. The data from these groups was then analyzed for differences in cognitive decline based upon Neuropsychological Battery Scores and a Clinician Dementia Rating (CDR) using a general linear model.ResultCognitive function tests looked at language, cognitive executive function, and verbal and nonverbal memory. Comparison of the mean scores in 16 selected tests from the Neuropsychological Battery test showed no significant differences in baseline scores and scores at subsequent visits between the T2DM and non‐diabetic groups.ConclusionUsing the NACC database, which receives longitudinal data from Alzheimer’s Disease research Centers (ADRCs), it was found that there were no differences in cognitive decline metrics over the course of 5 visits in either group. This supports the position that the presence of T2DM does not appear to increase the magnitude of cognitive decline in AD patients