We present an integrated system for training ultrasound (US) guided needle puncture. Our aim is to provide a validated training tool for interventional radiology (IR) that uses actual patient data. IR procedures are highly reliant on the sense of touch and so haptic hardware is an important part of our solution. A hybrid surface/volume haptic rendering of an US transducer is proposed to constrain the device to remain outside the bony structures when scanning the patient's skin. A volume haptic model is proposed that implements an effective model of needle puncture. Force measurements have been made on real tissue and the resulting data is incorporated into the model. The other input data required is a computed tomography (CT) scan of the patient that is used to create the patient specific models. It is also the data source for a novel simulation of a virtual US scanner, which is used to guide the needle to the correct location.

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Spinal epidural haematoma is a neurosurgical emergency characterised by extravasation of blood in the spinal epidural space. The clinical presentation particularly in young children can masquerade other conditions such as meningitis. In this article, we discuss our case and review the literature on spontaneous spinal epidural hematoma with an aim to improve awareness of this condition which if not recognised and treated early can lead to significant lifelong morbidity.

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A 16-year-old female presented with a sinus on the skin just medial to the right clavicle, which had discharged clear fluid on a daily basis for a number of years. A sinogram was performed and showed a long sinus tract extending from the region of the right clavicle to the lateral pharyngeal wall. Surgical treatment would have required an extensive procedure and seemed inappropriate in view of the relatively mild symptoms the patient was experiencing. Instead sclerotherapy was used to induce healing of the lesion. This was performed using 3% sodium tetradecyl sulphate foam delivered via a catheter along the entire length of the tract. There were no immediate complications from this procedure and on review at 1 and 6 weeks postprocedure the patient reported a significant improvement in the fluid discharge. At 1 year post-procedure this improvement had been sustained. The patient did report an occasional discharge from the sinus tract orifice at the base of her neck, but she did not feel that this was a significant problem and declined any further treatment.

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The growing field of interventional radiology provides a number of treatment options alternative to previous relied upon invasive surgeries. Pulmonary sequestration is a condition where the option of interventional radiology is particularly promising. Described is a 41-year-old male who elected alternative treatment for his symptomatic intralobar sequestration in order to avoid associated complications of extensive surgery. Specifically, this case reports a successful cure utilizing minimally invasive embolization with polyvinyl alcohol particles and coil placement.