Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease, is the fastest-growing cause of chronic liver disease worldwide, affecting approximately 30% of the global population.Imaging is vital for detecting, quantifying, and monitoring hepatic steatosis—the defining abnormality of MASLD—and subsequent fibrosis—the key determinant of liver-related outcomes. This review summarizes the principles, clinical usage, efficacy, and advancements in various imaging modalities for the noninvasive assessment of hepatic steatosis and fibrosis, with an emphasis on ultrasound, CT, and MRI. Additionally, this review explores the evolving landscape of MASLD diagnostic approaches, including machine-learning techniques, opportunistic screening, standardized imaging guidelines, and therapies, emphasizing the pivotal role that radiologists can play in shaping these developments.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Objective:To investigate the risk factors for new adjacent vertebral fracture after percutaneous kyphoplasty (PKP) in patients with osteoporotic vertebral compression fracture (OVCF) and their predictive efficacy.Methods:A retrospective cohort study was conducted to analyze the clinical data of 476 OVCF patients admitted to The Affiliated Wuxi People′s Hospital of Nanjing Medical University from January 2018 to December 2024, including 74 males and 402 females, aged 49-91 years [71(65, 79)years]. Among them, 397 patients underwent single-level PKP, while 79 received multi-level PKP. Surgical segments involved T 6 in 9 patients, T 7 in 9, T 8 in 14, T 9 in 12, T 10 in 9, T 11 in 50, T 12 in 110, L 1 in 173, L 2 in 77, L 3 in 46, L 4 in 31, and L 5 in 13. The patients were divided into adjacent vertebral fracture group ( n=55) and non-adjacent vertebral fracture group ( n=421) according to whether adjacent vertebral fracture was observed during the follow-up. The following data were collected in both groups: gender, age, body mass index (BMI), bone mineral density T-value, underlying diseases (hypertension, diabetes, coronary heart disease), prior cerebral infarction, history of OVCF, long-term glucocorticoid use, thoracolumbar fracture, number of operated vertebrae, cement injection approach (unilateral or bilateral), mean cement dose, postoperative vertebral height restoration rate, postoperative Cobb angle correction, postoperative thoracolumbar kyphosis angle correction, and cement distribution score. Univariate and multivariate Logistic stepwise regression analysis were performed to assess and identify independent risk factors for adjacent vertebral fracture in OVCF patients after PKP. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the risk factors′ predictive performance for adjacent vertebral fracture in OVCF patients after PKP. Results:Univariate analysis revealed significant differences in age, bone mineral density T-value, history of OVCF, long-term glucocorticoid use, number of operated vertebrae, and cement distribution score between the two groups ( P<0.05). The multivariate Logistic stepwise regression analysis showed that the bone mineral density T-value ( OR=0.68, 95% CI 0.48, 0.95, P<0.05) and cement distribution score ( OR=0.61, 95% CI 0.49, 0.76, P<0.01) were significantly correlated with new adjacent vertebral fractures after PKP. The ROC curve analysis showed that bone cement distribution score showed better predictive performance (AUC=0.72, 95% CI 0.64, 0.79), compared with bone mineral density T-value (AUC=0.62, 95% CI 0.54, 0.70), while the combined predictive performance of the two factors was the best (AUC=0.75, 95% CI 0.68, 0.81). Conclusions:Bone mineral density T-value and cement distribution score are independent risk factors for new adjacent vertebral fracture in OVCF patients after PKP. The predictive performance of cement distribution score is proved to be good and can be better in combination with bone mineral density T-value.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

Severe open tibiofibular fractures account for approximately 28.1% of all open fractures. Among them, Gustilo-Anderson type IIIB/C fractures present significant clinical challenges due to associated bone and soft tissue defects, high infection rates, and risk of amputation. Inadequate preoperative assessment may lead to suboptimal emergency surgical planning or intraoperative complications. Historically, external fixation was often preferred, but this approach has been associated with limitations such as restricted joint mobility, delayed bone union, joint stiffness, and disuse osteoporosis, resulting in poor functional recovery. With advancements of debridement techniques, standardization of antibiotic use, and popularization of early soft tissue coverage, early internal fixation has gained broader acceptance. Nevertheless, controversies persist regarding the choice of fixation method, timing of definitive fixation, use of reamed versus unreamed intramedullary nailing, and necessity of fibular fixation. To standardize the diagnosis and early management of severe open tibiofibular fractures, reduce complication rates, and improve functional recovery, the Society of Microsurgery of the Chinese Medical Association organized a panel of domestic experts to develop the Evidence-based guideline for the diagnosis and early fixation of severe open tibiofibular fractures ( version 2025), using evidence-based methodology. The guidelines provided 12 recommendations covering diagnostic and early fixation strategies of severe open tibiofibular fractures, aiming to provide clinicians with scientifically grounded and standardized guidance.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Objective:To investigate the risk factors for new adjacent vertebral fracture after percutaneous kyphoplasty (PKP) in patients with osteoporotic vertebral compression fracture (OVCF) and their predictive efficacy.Methods:A retrospective cohort study was conducted to analyze the clinical data of 476 OVCF patients admitted to The Affiliated Wuxi People′s Hospital of Nanjing Medical University from January 2018 to December 2024, including 74 males and 402 females, aged 49-91 years [71(65, 79)years]. Among them, 397 patients underwent single-level PKP, while 79 received multi-level PKP. Surgical segments involved T 6 in 9 patients, T 7 in 9, T 8 in 14, T 9 in 12, T 10 in 9, T 11 in 50, T 12 in 110, L 1 in 173, L 2 in 77, L 3 in 46, L 4 in 31, and L 5 in 13. The patients were divided into adjacent vertebral fracture group ( n=55) and non-adjacent vertebral fracture group ( n=421) according to whether adjacent vertebral fracture was observed during the follow-up. The following data were collected in both groups: gender, age, body mass index (BMI), bone mineral density T-value, underlying diseases (hypertension, diabetes, coronary heart disease), prior cerebral infarction, history of OVCF, long-term glucocorticoid use, thoracolumbar fracture, number of operated vertebrae, cement injection approach (unilateral or bilateral), mean cement dose, postoperative vertebral height restoration rate, postoperative Cobb angle correction, postoperative thoracolumbar kyphosis angle correction, and cement distribution score. Univariate and multivariate Logistic stepwise regression analysis were performed to assess and identify independent risk factors for adjacent vertebral fracture in OVCF patients after PKP. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the risk factors′ predictive performance for adjacent vertebral fracture in OVCF patients after PKP. Results:Univariate analysis revealed significant differences in age, bone mineral density T-value, history of OVCF, long-term glucocorticoid use, number of operated vertebrae, and cement distribution score between the two groups ( P<0.05). The multivariate Logistic stepwise regression analysis showed that the bone mineral density T-value ( OR=0.68, 95% CI 0.48, 0.95, P<0.05) and cement distribution score ( OR=0.61, 95% CI 0.49, 0.76, P<0.01) were significantly correlated with new adjacent vertebral fractures after PKP. The ROC curve analysis showed that bone cement distribution score showed better predictive performance (AUC=0.72, 95% CI 0.64, 0.79), compared with bone mineral density T-value (AUC=0.62, 95% CI 0.54, 0.70), while the combined predictive performance of the two factors was the best (AUC=0.75, 95% CI 0.68, 0.81). Conclusions:Bone mineral density T-value and cement distribution score are independent risk factors for new adjacent vertebral fracture in OVCF patients after PKP. The predictive performance of cement distribution score is proved to be good and can be better in combination with bone mineral density T-value.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

Severe open tibiofibular fractures account for approximately 28.1% of all open fractures. Among them, Gustilo-Anderson type IIIB/C fractures present significant clinical challenges due to associated bone and soft tissue defects, high infection rates, and risk of amputation. Inadequate preoperative assessment may lead to suboptimal emergency surgical planning or intraoperative complications. Historically, external fixation was often preferred, but this approach has been associated with limitations such as restricted joint mobility, delayed bone union, joint stiffness, and disuse osteoporosis, resulting in poor functional recovery. With advancements of debridement techniques, standardization of antibiotic use, and popularization of early soft tissue coverage, early internal fixation has gained broader acceptance. Nevertheless, controversies persist regarding the choice of fixation method, timing of definitive fixation, use of reamed versus unreamed intramedullary nailing, and necessity of fibular fixation. To standardize the diagnosis and early management of severe open tibiofibular fractures, reduce complication rates, and improve functional recovery, the Society of Microsurgery of the Chinese Medical Association organized a panel of domestic experts to develop the Evidence-based guideline for the diagnosis and early fixation of severe open tibiofibular fractures ( version 2025), using evidence-based methodology. The guidelines provided 12 recommendations covering diagnostic and early fixation strategies of severe open tibiofibular fractures, aiming to provide clinicians with scientifically grounded and standardized guidance.