Background: Anatomical, structural as well as severity of brachial plexus injuries is evaluated by magnetic resonance imaging which determines the type of treatment as well as the prognosis. However, limitations such as static imaging, availability, cost-effectiveness & complexity of procedure has led to search of cheaper diagnostic modalities like ultrasonography which has potency to overcome such limitations. Therefore, this study was carried out to assess efficacy of ultrasound in post ganglionic brachial plexus injury. Materials and Methods:A cross sectional comparative study was conducted in the department of Radio-diagnosis of Mahatma Gandhi Medical College and Research Institute from January 2021 to June 2022 amongst 23 patients diagnosed with traumatic & clinically consistent brachial plexus injury who underwent surgical intervention. The outcome measures assessed were level of injury, site of injury, neuroma, rupture, neuropraxia / nerve thickening / probable scar block. Results: The majority of the subjects were males, with left sided injuries accounting for 52.2%. Root injuries (47.8%) were more common than trunk, division (26% each). USG showed 81.8% sensitivity & 100% specificity for rupture; 100% sensitivity & 92.3% specificity for neuroma & 50% sensitivity for nerve thickening. We recorded sensitivity & specificity rate of 100% for rupture, neuroma & nerve thickening on assessment by MRI. USG could not pick up T1 root injuries and lower trunk injuries. Conclusion: Ultrasonography recorded a high degree of accuracy in identifying the postganglionic brachial plexus injury associated with proximal roots, divisions, upper and middle trunks in the lateral region of the neck while the imaging in lower trunk was limited. Therefore, we conclude that ultrasonography supersedes limitations of MRI such as static imaging, expensive & technique sensitivity, which makes it a more lucrative diagnostic modality for studying the brachial plexus in adjunct or absence of MRI.
Background: To determine any difference between the efficacy of water excitation sequence in comparison with fat suppression sequence in evaluating knee cartilage. Materials and Methods: This prospective study was conducted for a period of two years from January 2021 to June 2022 in Department of Radiodiagnosis, Mahatma Gandhi Medical College and Research Institute, Pondicherry.Results: In this prospective study carried out on 40 persons who came for MRI knee, the inter-observer agreement for cartilage visibility was same and found to be better in both the sequences. The inter-observer agreement for cartilage pathology was found to be same for MFC, LFC and MTP in both the sequences. However, the inter-observer agreement for cartilage pathology over Patella, Trochlea and LTP was found to be better in 3D water excitation sequence than 2D fat suppression sequence. Conclusion:We observe a significant improvement in the inter-observer agreement when evaluating knee cartilage using 3D-WATS sequences than using conventional 2D PD SE sequences.
Introduction: Hirayama disease is a form of cervical myelopathy common in male adolescents that affects distal upper extremities & anterior horn cells of spinal cord. It is a symmetrical lower motor weakness that is self-contained in hands & forearms. Materials and Methods: Observational type of case study using MRI. 16 years male presented with inability to move his right index finger & decreased sensations for 3 months Results: T2 sagittal images showed mild atrophy with flattening of cervical cord & displacement of posterior dura with compression on cord on dynamic flexion. Cord diameter was reduced suggestive of compression. Conclusion:Based on the patient's clinical, electrophysiological, & radiological characteristics, "Hirayama disease" was diagnosed. In addition to physiotherapy, a cervical collar was used to treat him in order to avoid neck flexion & thus surgery was avoided.
Background: Ultrasonography (USG) of abdomen remains one of the commonly asked investigations by the surgeon in patients with suspected acute abdomen. The advantage of USG over other radiological investigation is that it is easily available, cost effective, portable, no known side effects, non-invasive and requires minimal patient preparation for carrying out the examination. The present study aimed at evaluating ultrasonography findings of appendicitis and to correlate with operative and histo-pathological findings. Material and Methods: In our study, USG evaluation was done by the investigators for 61 clinically diagnosed patients, so as to achieve 50 radiologically confirmed appendicitis cases which was the required sample. The study was carried out from December 2013 to September 2015. Data was analysed using the statistical software SPSS version 21.0. Chi Square test was applied to test statistically significant difference in proportion. Results: In the present study the mean age the study participants was 26.42 years. Majority of the study participants were males 29 (58%) while females represented 42%.The average size of the appendix among the study participants was observed to be 7.08 mm with a standard deviation of ± 1.07 mm. Among all the study participants with acute appendicitis in our study 22% of the patients had perforation of appendix. In our study, we proved that all USG diagnosed appendicitis cases (100%) were histo-pathologically correct but the variations found in diagnosing the perforation status. We found that the USG had 73.33% and 100% sensitivity and specificity in finding the perforation status.
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