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Hair on end appearance of the skull
Diagnosis-thalassemia
Click on the link below--
http://www.mypacs.net/cgi-bin/repos/mpv3_repo/wrm/repo-view.pl?cx_subject=43117&mode=NOBANNER&bgcolor=BLACK&cx_image_only_mode=on&cx_prefsize=medium&cx_repo=mpv3_repo&cx_from_folder=#row1
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Posted in
September 2004
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BRAIN ABSCESS
CHECK THE LINK---
http://www.mypacs.net/cgi-bin/repos/mpv3_repo/wrm/repo-view.pl?cx_subject=87009&mode=NOBANNER&bgcolor=BLACK&cx_image_only_mode=on&cx_prefsize=medium&cx_repo=mpv3_repo&cx_from_folder=#row1
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Posted in
September 2004
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THE GOLDEN'S S-SIGN
Right upper lope collapse around a large central mass.
Discussion: The mass prevents the central part of the lobe from losing volume. Because the peripheral lobe collapses and the central portion doesn't, it appears convex centrally and concave peripherally. The shape therefore resembles an S or reverse S, and is called the Golden S sign after Golden's description of cases of lobar collapse caused by carcinoma of the lung.
CHECK THE LINK BELOW----
http://www.mypacs.net/cgi-bin/repos/mpv3_repo/wrm/repo-view.pl?cx_subject=22577&mode=NOBANNER&bgcolor=BLACK&cx_image_only_mode=on&cx_prefsize=medium&cx_repo=mpv3_repo&cx_from_folder=#row1
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Posted in
September 2004
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A Forty-year old man presented with complaint of mild pain right hypochondrium and frequent micturition for last ten months. On clinical examination there was mild hepatomegaly, spleen was not palpable. Chest and cardiovascular examination was normal. Laboratory results showed haemoglobin level of 13.2gm% and a total leucocyte count of 8900/mm3 with 5% eosinophilia. Blood urea levels, creatinine levels, and the results of liver function tests were normal. Examination of urine and faeces revealed no pathological findings.
Ultrasound examination of the abdomen was carried out. Liver showed a well-defined, multiseptae cystic lesion in the right lobe of liver anteriorly showing multiple daughter cysts classic appearance of a hydatid cyst. There was no evidence of calcification. Ultrasonography also revealed another well defined heteroechoic cystic lesion with evidence of internal septations in the pelvis posterior to the bladder displacing the bladder forwards. There was no evidence of calcification. No other cyst was noted. Chest X-Ray was normal. Indirect Hemagglutination test for E.granulosis was positive. A diagnosis of coexistent hepatic and pelvic hydatid was made.
Hydatid disease (Echinococcus granulosus) is endemic in India as well as other parts of the world, including Middle East, Africa, New Zealand, Australia, Turkey and Southern Europe. The clinical presentation of the hydatid disease depends on the size and the site of the lesion and accessibility of the organ involved for clinical examination. Eosinophilia can be present as expected for parasitic infestations. As in this case, the diagnosis of hydatid can be made with US and confirmed by a CT scan. The MRI is also helpful in cardiac and intracranial hydatidosis. Different serological tests can be carried out for the diagnosis, including enzyme-linked immunosorbent assay (ELISA) and indirect haemagglutination (IHA) test. [1]
Localisation of cysts is mostly hepatic or pulmonary but peritoneal, splenic, pancreatic, thyroid, muscular and bone lesions are also reported. Juxta vesical location, preponderantly retrovesical, is rare. The position follows a tear of a cyst in the superior abdominal area, usually hepatic or splenic, and the parasite settles in the pelvic region of the peritoneal cavity, where a new cyst forms. Such a rupture can occur spontaneously or result from trauma at the operation. Very often the pelvic cyst coexists with a hepatic one, detected before or on the same occasion, so that these cysts are secondary in most cases. [2]
Pelvic localization may be considered primary if no other site is found to be affected. Such cysts are mostly retrovesical and are even more rare. [3]
Most frequent presenting symptoms in retrovesical hydatid cyst are frequency, urgency, burning micturition and urinary retention. Although clinical symptoms and signs are not specific of retrovesical hydatid cyst, hydatiduria, which is characterized by the presence in urine of gelatinous material and membranes reminiscent of grape skins in texture, is pathognomonic of a hydatid cyst ruptured in the urinary tract. [4]
Ultrasonography is the key diagnostic tool in the cases of hydatid cyst. Sonographic appearance can be either a simple cyst containing no internal architecture except sand, cysts with detached endocyst secondary to rupture, cysts with daughter cysts and matrix and densely calcified masses. CT is useful when the diagnosis is in doubt or to determine the relation with other adjacent organs. [4]
Retrovesical hydatid cyst is uncommon even in endemic areas. It results from peritoneal seedling of a intraperitoneal cyst or from haematogenous dissemination. The present case highlights the role of Ultrasound in diagnosis of retrovesical hydatid cyst, a rare location for hydatid cyst.
REFERENCES
Abu-Eshy SA. Some rare presentations of hydatid cyst (Echinococcus granulosus). J R Coll Surg Edinb. 1998; 43(5): 347-52.
Neagu V, Ioanid PC. Juxtavesical hydatid cysts. Eur Urol. 1978; 4(2): 111-4.
Basaranoglu M, Sonsuz A, Perek A, Perek S, Akin P. Primary pelvic hydatid cyst. J Clin Gastroenterol. 1998; 26(2): 157-8.
Horchani A, Nouira Y, Chtourou M, Kacem M, Ben Safta Z. Retrovesical hydatid disease: a clinical study of 27 cases. Eur Urol. 200; 40(6): 655-60.
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Posted in
September 2004
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CT Pulmonary Angiography: A Comparative Analysis of the Utilization Patterns in Emergency Department and Hospitalized Patients Between 1998 and 2003.Prologo JD, Gilkeson RC, Diaz M, Asaad J.Department of Radiology, University Hospitals of Cleveland, 11100 Euclid Ave., Cleveland, OH 44106.
AJR Am J Roentgenol. 2004 Oct;183(4):1093-6
OBJECTIVE: The purpose of our study was to objectively examine the temporal utilization patterns of CT pulmonary angiography in emergency department and hospitalized patients in an academic tertiary care center. SUBJECTS AND METHODS: Patients who underwent CT examination for suspected pulmonary embolism either through our emergency department or as inpatients during a recent 9-month interval were identified. The absolute number of studies and incidence of positive results and ancillary findings were compared with similar data published from our institution during the corresponding 9-month interval in 1997-1998.
RESULTS: The overall number of patients imaged for pulmonary embolism was significantly greater in the 2002-2003 period than in the 1997-1998 period (homogeneity of rates = 88.45, p < 0.0001). The absolute number of scans obtained was significantly greater in both the emergency department (chi(2) = 167.03, p < 0.0001) and inpatient (chi(2) = 210.62, p < 0.0001) groups in the more recent population. Significantly fewer ancillary findings were reported in both the emergency department (chi(2) = 5.93, p = 0.019) and inpatient (chi(2) = 6.03, p = 0.015) groups in the more recent population. The incidence of CT-detected pulmonary embolism was significantly less in both the emergency department (chi(2) = 34.26, p < 0.0001) and inpatient (chi(2) = 8.52, p < 0.01) groups in the more recent population. This decrease in the incidence of scans with positive findings for pulmonary embolism over time was significantly greater in the emergency department group than the inpatient group (homogeneity of odds = 0.003, p < 0.007).
CONCLUSION: The evolution of CT pulmonary angiography utilization has led to a significant increase in the number of patients being imaged for pulmonary embolism with a coincident significant decrease in the rates of CT-detected pulmonary embolism and ancillary findings both in emergency department and hospitalized patients.
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Posted in
September 2004
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Second edition of review of radiology is out
second edition of review of radiology, by dr sumer k sethi, peepee publishers.. is out it is an edition which is updated with a radioloogical quiz and has recieved great reviews world over and is already recieving great feed back
check it out!!
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Posted in
September 2004
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For my critic i new quote.....
‘Education is when you read the fine print. Experiences is what you get if you don’t
PETE SEEGER.
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Posted in
September 2004
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Radiologists lead campaign to change ultrasound practice
Ultrasound is an ugly word in India because of the immediate connection it provokes with female foeticide. And sadly so, because there’s a lot more to ultrasound than pre-natal sex determination. Apart from being more affordable and accessible than other imaging techniques, ultrasound is extremely useful in the diagnosis of pregnancy abnormalities and diseases of the gall bladder and pancreas.
The Indian Radiological and Imaging Association (IRIA), which is campaigning to remove the stigma and restrict the practice of ultrasound only to doctors who have studied ultrasound as part of their postgraduate syllabus, will take up the issue of ultrasound practice once again with the Central Supervisory Board.
The Central Supervisory Board, constituted under the Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act (PNDT Act), is scheduled to meet on September 23 for the first time since the new government was formed. The meeting will be chaired by the Union Minister for Health and Family Welfare, Dr Anbumani Ramdass.
The board is responsible for reviewing the implementation of the act, and also for recommending any changes, if required, by the government.
The IRIA will be represented on the board by Dr C.S. Pant, past president of the association. Speaking to AuntMinnieIndia.com, Pant was emphatic that only doctors who have studied US in their postgraduate syllabus should be permitted to perform ultrasonography, which means only those with a two- or three-year postgraduate specialisation in gynaecology or radiology.
"On one hand, the government wants to prevent misuse of ultrasound. On the other hand, it is practically allowing everybody to do it," he said. The IRIA's stand is that restricting the practice of ultrasound to those who are either radiologists or gynaecologists will also reduce the misuse of the modality for sex determination.
For instance, the IRIA, as an association of radiologists, can take action against members who are misusing US. But with more than just radiologists performing US, the association has no control over the misuse of US.
"We are not claiming to curb it. But what we are saying is that we can control it," said Pant, admitting that merely restricting US practice to radiologists or gynaecologists will not eliminate the problem of female foeticide.
Backbone of radiology.
But the larger reason why the IRIA is pushing for US to be restricted to those with a postgraduate specialisation is because it believes that US is not a skill that can be learnt in six months or one year.
"If that's the case, then why have ultrasound as a postgraduate course in medicine?" Pant asked. It is the most widely taught subject in radiology in India and makes up close to 70% of the content of a radiology course in US, he said.
He likens the status of US today to the x-ray machine of yesteryear because of its availability. Unlike the more expensive CT and MRI units, ultrasound machines are affordable for nearly every medical university, making ultrasound a very widely taught modality.
"We are (contending) in the Supreme Court that only a radiologist who takes two years or three years to get trained, and then undergoes specialised training in US is qualified to perform US," said Col M.N. Sree Ram, central council member of the IRIA representing the armed forces. The matter is yet to come up for hearing.
Currently, anyone with a basic degree in medicine (MBBS) and even those with a degree from the Indian System of Medicine (including homeopathy, ayurveda, and unani) can practice US.
Harassment under PNDT Act
The IRIA has received complaints that its members are being harassed when they approach the district and state health authorities to register their facilities. Under the PNDT Act, hospitals, clinics, laboratories, and nursing homes that provide genetic counselling, conduct pre-natal diagnostic tests, and analyse test samples need to obtain a certificate of registration.
The act also states, "All records, charts, forms, reports, consent letters, and all other documents are required to be maintained under this Act, and the rules shall be preserved for a period of two years or for such period as may be prescribed."
According to Pant, there is scope for considerable ambiguity in the interpretation of the act, leading to harassment of radiologists. "There is no clear stipulation on the records that need to be maintained. There are no clear guidelines," he told AuntMinnieIndia.com. Harassment is one of the issues that the IRIA will take up at the upcoming Central Supervisory Board meeting.
Strangely, Pant also points out that the board does not have any radiologists among its members although US is performed by radiologists. He himself is a special invitee and not part of the board as envisaged under the PNDT Act. The board consists of geneticists, gynaecologists, paediatricians, social scientists, and representatives of women’s welfare organisations, among others
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Posted in
September 2004
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AIPG 2005 FORMS RELEASED
click on the link below for full information--
http://www.aiims.edu/aiims/events/result/aipgmee-05.htm
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Posted in
September 2004
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