An esophageal inlet patch is an area of heterotopic gastric mucosa in the upper esophagus. Most are asymptomatic and found incidentally. There are only 43 case reports of adenocarcinoma arising in an inlet patch, and the majority of these underwent surgical resection. We present the case of a 77-year-old man with intramucosal adenocarcinoma of the cervical esophagus, found within an esophageal inlet patch, staged T1a N0 Mx by endosonographic criteria. He was successfully treated with endoscopic therapy alone. One year following the endoscopic resection, there are no signs of residual or recurrent disease. This case highlights that adenocarcinoma can be a rare complication of an esophageal inlet patch, and that if found early, endoscopic resection appears safe and efficacious.

Hallux valgus is a common condition estimated to affect as many as 23% of adults. The condition is associated with a variety of debilitating symptoms leading to significant morbidity and quality of life issues. Proper evaluation of this deformity and the timely management of its symptoms can improve hallux valgus-related symptomatology and quality of life. The most commonly used and readily reproduced measurements for assessing hallux valgus are the inter-metatarsal angle and the hallux valgus angle. These angles are helpful for choosing and planning surgical intervention for patients who fail initial conservative measures with distal osteotomies reserved for mild or moderate hallux valgus and proximal osteotomies indicated for more moderate to severe deformities. After reading this review article, readers will gain knowledge of the etiopathogenesis of hallux valgus, measurement parameters, and treatment strategies with representative case examples.

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Radiofrequency ablation (RFA) has gained popularity as treatment for Barrett's esophagus. Inclusive series of patients from initiation of our Barrett's Therapy Program were studied. Review of patients undergoing RFA for Barrett's was performed from September 2008 to May 2011. Patients’ outcomes were recorded and analyzed using standard statistical methods. Seventy patients were treated. Average age was 61 (28–70); 80 per cent were male. Seventy-four per cent had dysplasia; 44 low-grade and eight high-grade. A total of 75.7 per cent of patients had long and 24.3 per cent had short segment Barrett's. Procedures per patient ranged from one to seven. Number of treatments in long- and short-segment groups were not different ( P = 0.11). The maximum number of treatments in the short-segment group was five with a median of three (44.3%). For long segment, the maximum of RFA procedures was seven, with a median of three (30.8%). Average procedure time was 20.8 minutes for long and 17.9 minutes for short segment. Mean follow-up was 16.1 (2–38) months. Complete response was accomplished in 81 per cent. There were 93.3 per cent of complete responders in the short-segment group versus 75 per cent in the long ( P = 0.24). Complications included dysphagia (1), transient chest and cervical pain (1), and abdominal pain (1). Comparing the first 25 per cent of the RFA procedures to the later 75 per cent or first 50 per cent to second 50 per cent, there was no difference in operative time or complications. Two patients recurred, both in the long-segment group. RFA is a safe and effective means to eradicate Barrett's. By measure of treatment time, complication rate, and efficacy of therapy, there is minimal or no “learning curve” for experienced endoscopists.

Purpose: To evaluate interreader performance in the measurement of the cross-sectional area and myosteatosis of pelvic skeletal muscles using fat quantification magnetic resonance imaging (MRI) and correlate with patient anthropomorphic characteristics. Materials and Methods: A Health Insurance Portability and Accountability Act–compliant retrospective cross-sectional study was performed. Between January and April 2016, 61 patients (26 males and 35 females) underwent a lumbosacral plexus 3T MRI with a modified three-dimensional spoiled gradient echo sequence dedicated to fat quantification (mDixon Quant; Philips Healthcare). Two independent reviewers outlined muscle cross-sectional area on axial images using a freehand region of interest tool and documented proton-density fat fraction (FF) and muscle area (cm 2 ) of the psoas, gluteus medius, gluteus maximus, and rectus femoris muscles on each side. Interreader agreement was assessed by intraclass correlation coefficient (ICC), and correlation between the measurements and subject's age, gender, and body mass index (BMI) was assessed using multiple linear regression analysis. Results: Excellent interreader agreement was obtained (ICC ≥0.74) for all muscle groups except for the left gluteus medius area and right psoas FF which showed good agreement (0.65 and 0.61, respectively). Statistically significant ( P ≤ 0.05) positive correlation was seen between the gluteal muscle FF and area with BMI, and rectus muscle FF with age and BMI. Statistically significant negative correlation between the rectus femoris area and age was also observed. Conclusion: Fat quantification MRI is a highly reproducible imaging technique for the assessment of myosteatosis and muscle size. Intramuscular FF and cross-sectional area were correlated with age and BMI across multiple muscle groups.