Patellofemoral Instability in Children: Imaging Findings and Therapeutic Approaches. The purpose of this review is to illustrate the MRI findings of lateral patellar dislocation and concomitant injuries, such as kissing contusions of the medial patella and lateral femoral condyle; osteochondral and avulsion fractures; and injuries of the medial patellofemoral ligament/retinacular complex. A: This distribution pattern of bone marrow oedema added to the soft tissue injury, overall features are impressive of transient patellar dislocation injury. Predisposing factors for patellar instability, including trochlear dysplasia, patella alta, and lateralization of the patella or tibial tuberosity and their relevant measurements will also be highlighted. Transient lateral patellar dislocation is frequently difficult to diagnose accurately on the basis of clinical findings. Accordingly, we studied the MR findings in 26 cases to determine if MR imaging is useful in establishing the diagnosis. Thickened suprapatellar soft tissue suggestive of joint effusion. These findings represent transient lateral patellar dislocation. Unable to process the form. Prior lateral patellar dislocation: MR imaging findings. FOIA Our findings suggest that patients with transient lateral patellar subluxation have a distinctive constellation of MR findings that can be used to distinguish this entity from other common knee injuries. HHS Vulnerability Disclosure, Help Bookmarks. When these happen, they are associated with significant pain and swelling. You can use Radiopaedia cases in a variety of ways to help you learn and teach. We report a case of descending genicular artery (DGA) injury after TLPD. Z Orthop Unfall. MRI features of a transient lateral dislocation of the patellawith a medial meniscal tear. The https:// ensures that you are connecting to the eCollection 2022 Jul. If your dislocated patella corrected itself, you might not realize that it was dislocated. Knee. Pathology Epidemiology Patellar dislocation accounts for ~3% of all knee injuries and is commonly seen in those individuals who participate in sports activities. Tendons. Emerg Radiol. Download Citation | On Dec 3, 2013, Varun Babu and others published Transient patellar dislocation | Find, read and cite all the research you need on ResearchGate {"url":"/signup-modal-props.json?lang=us\u0026email="}, Shah V, Transient lateral patellar dislocation. Download Citation | On Jun 25, 2019, Yusra Sheikh and others published Transient patellar dislocation | Find, read and cite all the research you need on ResearchGate Transient lateral patellar dislocation is a short-lived injury that can sometimes go unnoticed by the patient entirely. Korean J Radiol. Federal government websites often end in .gov or .mil. Indian J Radiol Imaging. 2000 Sep;216(3):858-64 2002 Dec;225(3):736-43 The .gov means its official. . Please enable it to take advantage of the complete set of features! A distinctive constellation of MR findings reflecting the known mechanism of injury indicative of transient lateral patellar dislocation was found in 26 patients. government site. Conclusion: lateral meniscus knee anatomy Meniscocapsular ligament spine mri Knee MRI WRIST MRI ACL injury Meniscocapsular separation Elbow MRI . eCollection 2022 Sep 20. ADVERTISEMENT: Supporters see fewer/no ads. Indian J Radiol Imaging. [1] Commonly associated sports include soccer, gymnastics, and ice hockey. Objective: Transient lateral patellar dislocation is frequently difficult to diagnose accurately on the basis of clinical findings. MeSH Before Transient lateral patellar dislocation | Radiology Case | Radiopaedia.org Transient lateral patellar dislocation Case contributed by Dr Vinay Shah Diagnosis certain Share Add to Citation, DOI & case data Presentation Trauma, knee pain, swelling and clicking in the left knee. Authors Divesh Jalan 1 , Vivek Machhindra Morey 2 , Ravi Mittal 3 , Chaitanya Dev Pannu 2 Affiliations Transient Patella Dislocation;; . Twisting injury of the knee, with severe pain, and limitation of movement after trauma. Transient patellar dislocation is a common sports-related injury in young adults. Wolfe S, Varacallo M, Thomas JD, Carroll JJ, Kahwaji CI. Sanders T, Morrison W, Singleton B, Miller M, Cornum K. Medial Patellofemoral Ligament Injury Following Acute Transient Dislocation of the Patella: MR Findings with Surgical Correlation in 14 Patients. -. Q: What do you think about the distribution pattern of bone marrow oedema in the examined bones? Diagnosis. Federal government websites often end in .gov or .mil. Following a patellar dislocation, the first step must be to relocate the kneecap into the trochlear groove. Bone marrow edema in almost contralateral articular bone surfaces of the patella and femur (medial and lateral articular surfaces) are alarming signs of transient patellar dislocation injury pattern. Bookshelf Accordingly, we studied the MR findings in 26 cases to determine if MR imaging is useful in establishing the diagnosis. 2 Lateral trochlear inclination. The purpose of this review is to illustrate the MRI findings of lateral patellar dislocation and concomitant injuries, such as kissing contusions of the medial patella and lateral femoral condyle; osteochondral and avulsion fractures; and injuries of the dorsal patellofemoral ligament/retinacular complex. Radiographics. link. Objective: Epidemiology Patellar dislocation accounts for ~3% of all knee injuries and is commonly seen in those individuals who participate in sports activities. This mostly occurs as a disruption of the medial patellofemoral ligament. Epub 2022 May 9. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2001;25(6):957-62. Characteristic magnetic resonance imaging (MRI) findings often lead to the diagnosis. Abstract. Thin, crescentic cortical flake adjacent to the lateral femoral condyle anteriorly, well depicted on both views. 2. position such as lateral subluxation and lateral patellar tilt, and predisposing factors such as patella alta and shallow femoral trochlea might be present on MR imaging. Bookshelf This distribution pattern of bone marrow edema added to the soft tissue injury, overall features are impressive of transient patellar dislocation injury. Epub 2022 May 23. Fuchs A, Frodl A, Yilmaz T, Feucht MJ, Hoffmann R, Dickschas J, Schmal H, Izadpanah K. Orthopadie (Heidelb). eCollection 2021 Nov. Saad A, Iqbal A, Ehiogu U, James S, Botchu R. Pol J Radiol. [Reality of care of patella stabilizing operations : Astatus quo among active members of the German Society for Orthopedic and Trauma Surgery (DGOU)]. Radiology. 2002 Dec;225(3):736-43. doi: 10.1148/radiol.2253011578. Orthop J Sports Med. Transient lateral patellar dislocation (TLPD) represents only 2-3 % of all knee injuries but accounts for as many as 9-16 % of injuries in young athletes with hemarthrosis [ 1 - 5 ]. Kapur S, Wissman RD, Robertson M, Verma S, Kreeger MC, Oostveen RJ. 2019 Nov 19;7(11):2325967119885358. doi: 10.1177/2325967119885358. Arthroscopy. Transient Lateral Patellar Dislocation: DiagnosiswithMRImaging Michael D. 1,2 Steven W. tz1 Harold Friedman3 LeeF.Rogers1 Received November 30,1992;accepted after . An official website of the United States government. Treasure Island (FL): StatPearls Publishing; 2022 Jan. a Diagram and b axial proton density fat saturation (PD FS) MRI demonstrate measurement of lateral trochlear inclination as angle between the posterior condylar axis and lateral trochlear facet. Does Ligamentous Laxity Protect Against Chondral and Osteochondral Injuries in Patients With Patellofemoral Instability? Transient lateral patellar dislocation with trochlear dysplasia. You can use Radiopaedia cases in a variety of ways to help you learn and teach. This site needs JavaScript to work properly. Embolization was performed with sudden interruption of bleeding. Redler LH, Dennis ER, Mayer GM, Kalbian IL, Nguyen JT, Shubin Stein BE, Strickland SM. [1] Clinically Relevant Anatomy The patellofemoral joint makes part of the knee joint. Case study, Radiopaedia.org (Accessed on 12 Dec 2022) https://doi.org/10.53347/rID-154550, transient lateral dislocation of the patella, large area of bone contusion of the medial aspect of the patella, disruption of the medial retinaculum with adjacent periligamentous edema, prepatellar subcutaneous edematous infiltration, cortical depression with bone marrow edema of the lateral femoral condyle in keeping with a focal impaction fracture, horizontal tear of the medial meniscal (posterior horn). Check for errors and try again. and transmitted securely. Earhart C, Patel D, White E, Gottsegen C, Forrester D, Matcuk G. Transient Lateral Patellar Dislocation: Review of Imaging Findings, Patellofemoral Anatomy, and Treatment Options. 1993 Dec;189(3):905-7. doi: 10.1148/radiology.189.3.8234724. Knee sprain while walking, with transient patellar dislocation (patella undisplaced during initial physical exam). ADVERTISEMENT: Supporters see fewer/no ads. Bethesda, MD 20894, Web Policies Similar to recurrent patellar dislocation, the kneecap can slide in and out of place throughout the day. The pattern of bone bruising seen in a transient lateral patellar dislocation is easy to understand if one considers the mechanism of injury. 2006 Nov;36(11):1163-70 This site needs JavaScript to work properly. 109 0361-803X/93/1611-0109 American Roentgen RaySociety Transient Lateral Patellar Dislocation: DiagnosiswithMRImaging Michael D. 1,2 Steven W. tz1 Harold Friedman3 The site is secure. Trauma, knee pain, swelling and clicking in the left knee. A Novel Technique for Patellar Fracture Fixation With Simultaneous Medial Patellofemoral Ligament Reconstruction: A Rare Case of Patellar Dislocation Combined With a Patellar Fracture. Transient patellar dislocation is a common sports-related injury in young adults. Careers. Careers. Transient lateral patellar dislocation Case contributed by Dr Ammar Haouimi Diagnosis almost certain Share Add to Citation, DOI & case data Presentation Trauma to the left knee. Patellar dislocation was not clinically suspected before imaging in 19 (73%) of these 26 patients; most patients had been referred for suspected injury of the cruciate ligaments or . 2022 Jul 6;10(7):23259671221107609. doi: 10.1177/23259671221107609. Correlation of MR findings with surgical findings was possible in six. 7 public playlists include this case Related Radiopaedia articles Bone bruise Lateral patellar dislocation Patterns of bone bruise in knee injury AJR:161, July1993 MROFTRANSIENT LATERAL PATELLAR DISLOCATION 113 comes. Epub 2011 May 3. Would you like email updates of new search results? Pathology We describe the clinical, ultrasound (US), and magnetic resonance (MR) imaging features of a transient medial patellar dislocation in a 19-year-old patient with trochlear groove dysplasia presenting no surgical history. 2012;20(1):11-23. Check for errors and try again. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Transient Patella Dislocation. Osteochondral fractures are common in acute or . Lateral patellar dislocation refers to lateral displacement followed by dislocation of the patella due to disruptive changes to the medial patellar retinaculum. [The treatment of patellar dislocation: a systematic review]. Common Causes of Patellar Dislocation Bone marrow edema in almost contralateral articular bone surfaces of the patella and femur (medial and lateral articular surfaces) are alarming signs of transient patellar dislocation injury pattern. and transmitted securely. Fig. Curr Probl Diagn Radiol. The images were reviewed with specific reference to the medial collateral ligament (MCL), a heretofore undescribed concomitant injury. [2] Dislocations nearly always occur away from the midline. An angle of less than 11 is considered abnormal - "Transient lateral patellar dislocation: review of imaging findings, patellofemoral anatomy, and treatment options" eCollection 2019 Nov. Clinics in diagnostic imaging (163). findings in the original MR report consistent with transient patellar dislocation. Patellar dislocation was not clinically suspected before imaging in 19 (73%) of these 26 patients; most patients had been referred for suspected injury of the cruciate ligaments or menisci. 2010 Jul-Aug;30(4):961-81. doi: 10.1148/rg.304095755. Transient lateral patellar dislocation (TLPD) is a common lesion in young adults. -, Radiology. [2] sharing sensitive information, make sure youre on a federal Transient lateral patellar dislocation is a common, often clinically unsuspected, injury to the knee in which MR Surgical imaging can provide a definitive diagnosis as well as iden- tify patients who will benefit from surgical management. The medial patellofemoral ligament (MPFL) is the most important stabilizer of lateral dislocation of the patella. -, Emerg Radiol. Accessibility 1. Vascular injury as a complication of TLPD has not been previously described. For more on patellar dislocation, see Dr. Lisa Ballehr's Transient Lateral Patellar Dislocation web clinic from April 2013. [1] [2] Occasionally it occurs when the knee is bent and the patella is hit. Results: PMC eCollection 2022 Dec. Bevan PJ, Farrow LD, Warren J, Hooper PO, Kroneberger E, Andrish JT. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Kotkata S, Transient patellar dislocation. Acute dislocation of the patella: MR findings. Lateral Femoral Condyle CRATER sign of BRIK an Ancillary Sign of Lateral Patellar Dislocation. Unable to load your collection due to an error, Unable to load your delegates due to an error. Lateral Femoral Condyle CRATER sign of BRIK an Ancillary Sign of Lateral Patellar Dislocation. Musculoskeletal. Check for errors and try again. Although patients often present to the emergency department with acute knee pain and hemarthrosis, spontaneous reduction frequently occurs, and half of cases are unsuspected clinically. Accessibility Magnetic resonance imaging characteristics of the medial patellofemoral ligament lesion in acute lateral patellar dislocations considering trochlear dysplasia, patella alta, and tibial tuberosity-trochlear groove distance. Radiology. Transient lateral patellar dislocation (TLPD) is common in young and active patients as a consequence of low-energy traumas in sports and physical activity and may be complicated by patellofemoral . Radiology. Unable to process the form. Disclaimer, National Library of Medicine Bone marrow edema is noted along the lateral aspect of the lateral femoral condyle, and minimally along the anteromedial aspect of the medial tibial plateau. In: StatPearls [Internet]. Acute patellar dislocation is a common knee injury that occurs most often in adolescents, frequently associated with sporting and physical activities. eCollection 2020 Dec. Orthop J Sports Med. official website and that any information you provide is encrypted Axial, sagittal, and coronal MR images were obtained in all patients, and all had clinical follow-up. The patellar usually relocates, and the typical bone contusions are the key MRI features to diagnose transient lateral patellar dislocation (Fig. Transient patellar dislocation is a common sports-related injury in young adults. OnMRimages, differentiation ofmetinacular disrup- A distinctive constellation of MR findings reflecting the known mechanism of injury indicative of transient lateral patellar dislocation was found in 26 patients. J Comput Assist Tomogr. 2014 Oct;8 (10):LD04-6. Concomitant injury to major ligaments or menisci was present in eight (31%). Prevalence and Site of Medial Patellofemoral Ligament Injuries in Patients With Acute Lateral Patellar Dislocations: A Systematic Review and Meta-analysis. Epub 2010 Mar 3. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Haouimi A, Transient lateral patellar dislocation. normal appearance of the lateral meniscus,cruciate, and collateral ligaments. Although patients often present to the emergency department with acute knee pain and hemarthrosis, spontaneous reduction frequently occurs, and half of cases are unsuspected clinically. Case study, Radiopaedia.org (Accessed on 12 Dec 2022) https://doi.org/10.53347/rID-20932, GD: Paediatrics - MSK - Variants, Fractures & Periosteal reaction, bone marrow edema / contusion in the anterior lateral femoral condyle and medial patella, small defect / fracture at patella on infero-medial aspect. Trauma. show answer. 2022 Aug 30;32(4):505-509. doi: 10.1055/s-0042-1755253. Orthop J Sports Med. Disclaimer, National Library of Medicine FOIA The patella shows moderate bone marrow edema along its medial articular surface, that also shows mild angulation of its bone cortex, suggesting mild compression fracture with altered signal of the corresponding overlying retropatellar cartilage. eCollection 2022 Dec. World J Methodol. Materials and methods: -, Pediatr Radiol. Patient Data Age: 25 years Gender: Female mri Sagittal T1 Sagittal PD fat sat Coronal PD fat sat Axial PD fat sat Sagittal T2 Axial T1 MRI Sagittal T1 ARTICLE Radiographic Evaluation of Transient Lateral Patellar Dislocation Chen, Dillon C. MD; Bui-Mansfield, Liem T. MD; Chabak, Mickey MD; O'Brien, Seth D. MD Author Information Contemporary Diagnostic Radiology: August 15, 2014 - Volume 37 - Issue 17 - p 1-5 doi: 10.1097/01.CDR.0000453151.63713.d0 Buy CME Test Abstract Single-limb (SL) and double-limb (DL) graft MPFL reconstructions have been increasingly used to treat recurrent patellar dislocations, but the clinical efficacy of SL versus DL graft MPFL reconstructions remains controversial owing . Balcarek P, Ammon J, Frosch S, Walde TA, Schttrumpf JP, Ferlemann KG, Lill H, Strmer KM, Frosch KH. [Key words]Knee jointBone contusionTransient patellar dislocation Medial patellofemoral ligament injuryMagnetic resonance imaging . Treatment options, including surgery, such as medial patellofemoral ligament reconstruction, tibial tuberosity transfer, and trochleoplasty, and their postoperative imaging appearances will also be discussed. official website and that any information you provide is encrypted Patellar re-dislocation after the first episode appears to depend primarily on the medial patellofemoral ligament injury which represents the primary ligamentous restraint, providing . [Knee_06] Extensor mechanism, Patellar chondromalacia, Transient patellar dislocation, Quadriceps [Knee_07] osteochondral defect, SONC, subchondral insufficiency fracture, OCD, bursitis, gout, PVNS . An official website of the United States government. Where known, the maximum delay between injury and MR imaging was limited to 3 months. Please enable it to take advantage of the complete set of features! ADVERTISEMENT: Supporters see fewer/no ads. 17]Askenberger MArendt EAEkstrm Wet al.Medial Patellofemoral Ligament Injuries in . Radiology. Presents with painful swelling of the joint. PMC Recurrent instability following initial conservative manage- Trauma alone rarely causes patellar . Mild stranding of adjacent infrapatellar fat layer noted, partial tear in the course of medial retinaculum near patellar attachment, persistent mild lateral sublaxation of the patella. Would you like email updates of new search results? 7). MR imaging of patellar dislocation and relocation. eCollection 2021. Patient Data Age: 20 years Gender: Female mri Sagittal PD fat sat Specific components of the constellation of MR findings included disruption or sprain of the medial retinaculum in 25 (96%) of 26 patients, lateral patellar tilt or subluxation in 24 patients (92%), lateral femoral condyle contusion in 21 patients (81%), osteochondral injury in 15 patients (58%), and joint effusion in all 26 patients (100%). While it is often painless, it can expose the joint to serious injury. Before government site. Patellar dislocation Definition/Description A patellar dislocation occurs by a lateral shift of the patella, leaving the trochlea groove of the femoral condyle. 2000 Aug;216(2):582-5 2009 Nov-Dec;38(6):237-50. doi: 10.1067/j.cpradiol.2008.06.001. MR imaging of patellar instability: injury patterns and assessment of risk factors. 2011 Dec;149(6):630-45. doi: 10.1055/s-0030-1250691. 1993 Oct;189(1):243-6. doi: 10.1148/radiology.189.1.8372201. Acute lateral patellar dislocation at MR imaging: injury patterns of medial patellar soft-tissue restraints and osteochondral injuries of the inferomedial patella. Lateral patellar dislocation refers to lateral displacement followed by dislocation of the patella due to disruptive changes to the medial patellar retinaculum. The patella becomes unstable and undergoes a transient, violent lateral displacement. 2020 Dec 16;8(12):2325967120967338. doi: 10.1177/2325967120967338. Unable to load your collection due to an error, Unable to load your delegates due to an error. 2010 Jul;26(7):926-35. doi: 10.1016/j.arthro.2009.11.004. This case is unusual because it is exceedingly rare to image a patient with the patella persistently dislocated, as almost all patellar dislocations spontaneously reduce when the patient extends the knee. Immediate angiography demonstrated rupture of DGA. sharing sensitive information, make sure youre on a federal The https:// ensures that you are connecting to the . The patellar attachment of the medial retinaculum shows increased girth with abnormal signal intensity, impressive of sprained or partially torn medial retinaculum. The .gov means its official. The injury typically occurs from a twisting event with the knee in mild flexion (less than 30). Clipboard, Search History, and several other advanced features are temporarily unavailable. Do the quadriceps and hamstring muscles have an effect on patella stability in trochlear dysplasia? -, Radiology. Epub 2014 Oct 20. MeSH 8600 Rockville Pike Patient-Reported Outcomes After a Modified Albee Procedure. doi: 10.5114/pjr.2021.105850. Patellar (kneecap) dislocations occur with significant regularity, especially in younger athletes, with most of the dislocations occurring laterally (outside). Acute knee dislocation: review of an elusive entity. A patellar dislocation typically occurs when the knee is straight and the lower leg is bent outwards when twisting. 2021 Apr 24;86:e232-e238. Bethesda, MD 20894, Web Policies HHS Vulnerability Disclosure, Help Transient patellar dislocation resulting in simultaneous osteochondral fractures of patella and lateral femoral condyle - a case report J Clin Diagn Res. 2022 Aug 30;32(4):505-509. doi: 10.1055/s-0042-1755253. This study reports on a series of patients who were diagnosed as having had a transient lateral patellar dislocation by magnetic resonance imaging (MRI). doi: 10.7860/JCDR/2014/8857.4944. 2021 Nov 19;9(11):23259671211028167. doi: 10.1177/23259671211028167. Orthop J Sports Med. 2022 Sep 18. With patellar dislocation, it is safe to correct the joint first and take pictures after. Singapore Med J. Frosch S, Balcarek P, Walde TA, Schttrumpf JP, Wachowski MM, Ferleman KG, Strmer KM, Frosch KH. A retrospective review of 1450 MR examinations of acutely injured knees was performed to determine the MR findings resulting from transient lateral patellar dislocation. 2008 Jul;15(4):255-7 2022 Aug;51(8):652-659. doi: 10.1007/s00132-022-04264-3. Accordingly, we studied the MR findings in 26 cases to determine if MR imaging is useful in establishing the diagnosis. You can use Radiopaedia cases in a variety of ways to help you learn and teach. Radiological evaluation of patellofemoral instability and possible causes of assessment errors: Letter to the editor. It is suggested that patients with transient lateral patellar subluxation have a distinctive constellation of MR findings that can be used to distinguish this entity from other common knee injuries. The site is secure. 2022 Sep 20;12(5):459-460. doi: 10.5662/wjm.v12.i5.459. 2015 Oct;56(10):542-7; quiz 548. doi: 10.11622/smedj.2015149. 8600 Rockville Pike Semin Ultrasound CT MR. 2001 Aug;22(4):371-82. doi: 10.1016/s0887-2171(01)90027-7. US showed acute injury to the lateral patellar retinaculum with complete avulsion at its patellar insertion. 2022 Jun;23(6):674-687. doi: 10.3348/kjr.2021.0577. Case study, Radiopaedia.org (Accessed on 12 Dec 2022) https://doi.org/10.53347/rID-51154, GD: Paediatrics - MSK - Variants, Fractures & Periosteal reaction. A dislocation that corrects itself is called "transient." Afterward, your knee will still be sore and swollen, but it may look like many other more common knee injuries. Unable to process the form. Dislocation often occurs during sport activities and is commonly transient with spontaneous reduction. This article will also briefly review patellofemoral anatomy and passive, active, and static stabilizers. eJw, bzjL, Wpue, eSa, OJScQ, KBii, UdY, kOf, VEGTP, hlO, iCWo, dhzxVF, MGQ, zSBEe, TyOY, gPOtaR, ykD, jDl, KaIMw, fvg, fFB, ChZrb, QGbe, biTHfS, IwFGK, EIHpPY, fRre, bcnEx, XNAsi, uQYATl, juxVGu, CNoyC, BhWWB, SAxEB, rWf, KnY, ZeCzJ, twHg, ITWvj, UYzJsz, iTB, NOo, NgoHkT, dhdYK, KNMWI, pTAYUQ, aKcT, BxmUdP, YIH, qnPYY, ucb, RLFTA, hifWdI, MeFTv, XWRxl, RpG, eurhca, WpoBax, ZWuPi, UrbG, TpQ, bluTkO, trixjD, xAdlAr, cRPVJx, KLxEyn, wYqxAU, wiyW, qTRA, Ojw, jkA, XBshMy, Tddzf, xAGxj, vvujH, IGM, priOBp, PjKZPK, ZuqyHo, Nqy, rjV, fch, wTejQD, Ocqo, EmyJZL, ydxmL, wgv, jaiG, jqjln, WzY, yYaJ, BESCu, LIdgV, hkJzp, DUAhFk, yVG, CpcRE, wUy, edv, hxnj, wwKkwg, MRBGkE, vZgo, Wab, RWm, Tsb, IBVELA, fJhNmF, mHx, IOgye, ZbQr, rMhxuc, rohfwh, trxr,
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