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Lipoma arborescens is a rare synovial pathology that is most commonly seen in the knee joint. Only a few cases of this condition have been reported in the hip joint. In present case, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) findings in a case of Lipoma arborescens of the hip joint in association with ankylosing spondylitis is reported. more...

Introduction: Elastography is a new technique that aim to assess tissue hardness non-invasively. Recently, it has been used for differentiating benign from malignant lymphadenopathy. Aim: To evaluate the sensitivity and specificity of elastography for differentiating benign from malignant cervical lymphadenopathy and to compare its findings with B-mode and color doppler findings. Materials and Methods: The present study was conducted on 50 patients with cervical lymphadenopathy. In each patient, even if multiple enlarged lymph nodes were found, only one lymph node was sampled which was most suspicious for malignancy. This selection was based on size of the lymph node and other B-mode sonography characteristics. B-mode and color doppler findings were recorded. In addition to this, strain elastography was done and five elastography patterns were defined: high elasticity (soft): pattern I represented no or very small hard area while spectrum pattern V presented where almost whole of lymph node showed hard pattern on strain elastography. Patterns II and III represented hard areas 45% respectively while pattern IV represented peripheral hard area with central soft area (due to central necrosis). Patterns I and II were considered benign. Patterns III, IV and V were considered to represent malignant lymph nodes. Additionally, a cine loop of elastography was acquired for calculation of strain ratio using adjacent muscle as reference. A cut-off value of less then two ( more...

Introduction: Multidetector Computed Tomography (MDCT) provides clinically and surgically important information in bowel obstruction. It can depict the severity, level and cause of obstruction. Aim: To depict the spectrum of MDCT findings in cases of small and large bowel obstruction. Materials and Methods: Contrast enhanced MDCT examination of 50 patients were retrospectively included in the study who had evidence of clinical as well as MDCT evidence of bowel obstruction and in whom surgical/clinical follow-up for final diagnosis was available. CT scan was done in all the patients with Ingenuity CT (128 slice MDCT, Philips Medical Systems). The axial sections were reconstructed in coronal and sagital planes to determine site and cause of bowel obstruction. Results: There were 34 males and 16 females patients in this study with mean age of 28.4 years. The level of obstruction was in small bowel in 39 patients (76.67%) and large bowel in 11 patients (23.33%). Adhesive bands were the cause of Small Bowel Obstruction (SBO) in 17 patients (43.5% of SBO patients). The most common CT signs in adhesive band SBO were beak sign (seen in 70.6% patients) and fat notch sign (52.9% patients). Five cases of SBO were secondary to benign stricture. Matted adhesions were the cause of obstruction in 3 patients. All these patients showed transition zone in pelvis with positive small bowel faeces sign. Two patients with SBO due to adhesive band had evidence of closed loop obstruction with evidence of gangrenous gut on surgery. Large Bowel Obstruction (LBO) was seen in 11 patients. Most common cause of LBO was primary colonic malignancy, accounting for 7 patients (63.6%). In one patient, the cause was direct invasion of hepatic flexure by carcinoma of gall bladder. Other causes of LBO were pelvic adhesions, faecal impaction and ischaemic stricture. Conclusion: SBO is more common than LBO with adhesive bands being the most common cause of SBO. MDCT is very useful for depicting site and cause of obstruction and any associated complications. more...

Introduction: Spinal trauma is relatively more common in young active individuals. Although its mortality is low, it is an important cause of long term disability. Magnetic resonance imaging (MRI) can accurately depict presence and extent of spinal cord injury (SCI) in these patients. This study was aimed to look for various qualitative and quantitative MRI findings which are predictive of initial neurological deficit in patients with spinal trauma and final outcome on follow-up. Materials and Methods: The present study was conducted on 50 patients with suspected acute cervical or dorsal spinal trauma presenting for MRI study. American Spinal Injury Association (ASIA) motor score was used for assessing neurological status at the time of presentation, at the time of discharge/2weeks and at 3-6 months follow up. Various MRI qualitative and quantitative parameters were evaluated for correlation with severity of spinal injury. Results: Normal baseline MRI (pattern 0) was seen in 12 subjects and was associated with incomplete SCI in 4 subjects (ASIA grade D) followed by complete recovery in all patients on follow-up examination. Pattern I (haemorrhage) was associated with complete spinal cord injury. Pattern II (oedema) was associated with incomplete SCI and good functional recovery on follow up.Pattern III (contusion) was associated with intermediate severity of injury. Compression and transection patterns were associated with complete neurological deficit at presentation and increased mortality at subsequent follow-up. All the three quantitative parameters i.e. lesion length,maximum (bony) canal compromise (MCC), maximum spinal cord compression (MSCC) were significantly increased in patients with complete SCI as compared to those with incomplete SCI. The best predictors for baseline ASIA score were MCC, cord oedema and cord haemorrhage. For the final ASIA score, the best predictors were baseline ASIA score and cord haemorrhage. Conclusion: MRI is excellent imaging modality for detecting and assessing severity of spinal trauma. In our study, presence of cord haemorrhage, MCC and cord oedema were best predictors of baseline neurological status at presentation, whereas baseline ASIA score and cord haemorrhage were best predictors of final neurological outcome. more...