re studies in this area. Bullying is destructive and pervasive. Although the literature suggests children with chronic health conditions are at higher risk of being bullied, there is minimal research regarding the prevalence of bullying among children with orthopaedic conditions. Our study aimed to assess the prevalence of bullying among pediatric orthopaedic outpatients and evaluate the association of orthopaedic conditions and use of orthopaedic devices with perceptions of bullying. Patients in outpatient pediatric orthopaedic clinics, ages 10 to 17 and their parents were surveyed using the Child-Adolescent Bullying Scale-9. Basic demographic, information about the child's orthopaedic condition, and parent's perception of their child being subject to bullying were also collected. Children were asked if they had used any orthopaedic devices in the last 3 months, whether they were bullied because of their device, and if bullying affected their compliance with device use. The analysis utilized a t test or analysis of variance to c to bullying may be higher in certain diagnoses or with use of certain orthopaedic devices. Further research is needed to delineate who is at highest risk. Level IV.Level IV. To investigate patient demographics, injury characteristics, radiographic outcomes, and identify risk factors for developing post-traumatic arthritis in high energy transsyndesmotic ankle fracture dislocations, or "Logsplitter" injuries. Retrospective cohort study. Academic level one trauma center. Twenty-seven adult patients with logsplitter injuries. All patients were treated with open reduction internal fixation, with possible addition of syndesmosis screw(s) and deltoid repair. Rate of post-traumatic arthritis at one year along with rate and reasons for reoperation. Twenty-seven patients were included with mean follow up of 14.5+/-12.5 months. At one year postoperative, 14/20 patients (70%) demonstrated posttraumatic arthritis. Two patients (7.4%) went onto fusion. Reoperation rate was 51.9%. There was no significant difference in arthritis rate with the number of syndesmosis screws used, quality of reduction, or the addition of deltoid repair. The logsplitter injury is one with devastating outcomes and high rates of arthritis; it should be considered separately from conventional ankle fractures. The role of deltoid repair remains unclear. Further study of this injury pattern is required. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. To examine the impact of fascia iliaca blocks performed in the emergency department on hip fracture patients on opioid consumption, length of stay, and readmission rate. Prospective cohort study. Community-based level 1 trauma centerPatients/Participants Ninety-eight patients with isolated femoral neck, intertrochanteric, and subtrochanteric femur fractures (OTA/AO 31-A and 31-B)1 presenting from January 1, 2020 to June 30, 2020. Ultrasound-guided fascia iliaca compartment block using 40mL of 0.25% bupivacaine. Opioid consumption, length of stay, discharge disposition, and 30-day readmission rate. Thirty-three patients had contraindication to FIB. Thirty-nine of 65 patients (60%) without contraindications to undergoing FIB received fascia iliaca block. Mean age, BMI, fracture type, and surgical procedure were similar between patients undergoing FIB and not receiving FIB. The FIB group had significantly lower opioid consumption pre-operatively (17.4 vs 32.0 MMEs), post-operatively (37.1 vs 85.5 MMEs), over total hospital stay (54.5 vs 117.5 MMEs), and mean opioid consumption per day of hospital stay (13.3 vs 24.0 MMEs). Patients in FIB group had shorter length of stay compared to control group (4.3 vs 5.2 days). Gunagratinib in vivo There was no significant difference in discharge disposition destination between groups. No patients reported complications of FI block. Undergoing fascia iliaca block in the emergency department was associated with decreased opioid consumption, decreased length of stay, and decreased hospital readmission within 30 days of hip fracture. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. Data on the etiological factors underlying the co-occurrence of common adolescent pain with anxiety and depression symptoms are very limited. Opioid prescriptions for adolescent pain problems are on the rise in North America and constitute a risk factor for diversion, misuse and substance use. In this study, we aimed to investigate the phenotypic and etiological association among pain, depression, and anxiety, and to test their link to substance use in adolescents.By taking advantage of the Italian National Twin Registry and of the relatively low incidence of opioid prescriptions in Italy, we applied multivariate modelling analyses to 748 Italian adolescent twins (374 pairs, mean age 16+1.24 years). Twins' responses to the Achenbach Youth Self-Report questionnaire (YSR) were used to build a composite adolescent pain index, and to measure anxiety, depression and substance use.All monozygotic within-pair correlations were higher than the dizygotic correlations, indicating genetic influences for adolescent paitypes was positively associated (β=0.19, p less then 0.001, CI 0.10-0.27) with substance use.These findings indicate that several intertwined mechanisms, including genetic factors, can explain a shared liability to common adolescent pain, anxiety and depression problems. Their association with substance use remains traceable even in societies with relatively low prevalence of opioid prescriptions. Reactive arthritis (ReA) is a sterile arthritis that occurs in genetically predisposed individuals secondary to an extra-articular infection, usually of the gastrointestinal or genitourinary tract. Sterile arthritis associated with instillation of intravesical bacillus Calmette-Guérin (iBCG) therapy used for bladder cancer can also be included under ReA based on the pathogenic mechanism. Similar to spondyloarthritis, HLA-B27 positivity is a known contributor to the genetic susceptibility underlying iBCG-associated ReA. Other genetic factors, such as HLA-B39 and HLA-B51, especially in Japanese patients, can also be involved in the pathophysiology of iBCG-associated ReA. The frequencies of ReA- and ReA-related symptoms are slightly different between Japanese and Western studies. Proper understanding of possible complications, their epidemiology and pathogenesis, and their management is important for the rheumatologist when noting symptomatic patients using iBCG. Herein, we will review the most current information on ReA after iBCG therapy.