MRI diagnosis of carpal boss and comparison with radiography

Background: A carpal boss is a potentially painful bony mass in the region of the second or third carpometacarpal joint. The combination of clinical examination and radiography is usually sufficient for the diagnosis. Purpose: To determine whether magnetic resonance imaging (MRI) examination of the quadrangular joint can assist the diagnosis of persistent pain near a carpal boss. Material and Methods: Fifty-seven patients with a carpal boss were retrospectively reviewed using MRI and conventional radiographs and compared to an asymptomatic control group. Results: MRI demonstrated a variable morphology and a variety of bone and soft tissue abnormalities associated with carpal boss. Bone marrow edema around the quadrangular joint shows a significant correlation (Fisher's exact test: P< 0.001) and a positive correlation (Pearson's test r = 0.632, significant at the 0.01 level [two-tailed]) with a painful carpal boss. Conclusion: MRI offers detailed examination of bone and soft tissue abnormalities associated with a carpal boss. Local bone marrow edema strongly correlates with a painful carpal boss

The Nature of Relationships in e-Internships: A Matter of the Psychological Contract, Communication and Relational Investment

Virtual internships (or e-internships) represent unique transitional and temporary learning experiences that have not been studied widely. Using 18 interviews conducted with interns and internship providers, the authors explored the extent to which psychological contracts appear to emerge and operate within this computer-mediated context. The results were d using thematic analysis. The findings indicate that while e-internships are temporary and hence transitional, they are not inevitably transactional. Relational and balanced contract characteristics are not necessarily uncommon in e-internships when these feature supervisory engagement and commitment to the e-internship as well as the customized use of technology to interact, monitor, and engage with interns

Indirect and direct measures of striving for perfection moderate BMI curves in the intensive treatment of anorexia nervosa.

The aim of this study was to investigate whether indirectly and directly assessed disorder-relevant attributes moderate the Body Mass Index (BMI) curves over the course of treatment in anorexia nervosa, as is predicted by dual process models. The moderating role of two Implicit Association Tests (IAT) and of two questionnaires assessing aspects of striving for perfection were examined in 27 patients by means of Linear Mixed Models. The Aiming at Perfection Single Category-IAT and the directly assessed achievement striving dimension of perfectionism moderated patients’ BMI curves over the course of treatment. Moreover, the Single Category-IAT predicted the outcome variable over and above the directly assessed attribute. Experiencing oneself as more achievement striving compared to others at an automatic level, predicted a faster weight gain. These findings show that aspects of multi-dimensional perfectionism - assessed at the automatic and at the reflective level - predict treatment outcome in anorexia nervosa.status: publishe