BACKGROUND 1. To evaluate the incidence and coexistence of multiple knee joint pathologies causing painful knee and their correlation to age and sex. 2. To evaluate the Magnetic Resonance Imaging (MRI) features in various knee pathologies and to identify the common lesions. MATERIALS AND METHODS A retrospective study was performed using the clinical data of patients presenting with painful knee joint which were evaluated with MRI. Data from 200 patients examined between September 2015 and August 2016 were included into this study. The data was analysed statistically to evaluate the correlation between the MR pathological findings to age and sex of the patients. RESULTS The patient's age ranged between 8 and 75 years (mean: 36 years). Anterior cruciate ligament (ACL) tear was the commonest finding (60%) followed by bursitis (55%), meniscal degeneration (54.6%) and meniscal tear (52%). Primary signs of ACL tear were hyperintensity, discontinuity and nonvisualisation. Secondary signs like Posterior cruciate ligament (PCL) buckling, PCL index of greater than 0.5, uncovered Lateral meniscus (LM) and bone contusion assisted in diagnosis in indeterminate cases. Mid substance was the commonest site of ACL tear (64%). PCL tear accounted for only a small percentage (7%). Medial Meniscus (MM) tear (35%) was commoner than LM tear (17%). The posterior horn of meniscus was the commonest site of injury (86.5%). Age was significantly correlated with meniscal degeneration and tear, Medial collateral ligament (MCL) degeneration, parameniscal cyst, and chondromalacia patellae. A significant correlation between male gender and ACL injury was noted. Meniscal injury was significantly correlated with bursitis, as well with MCL injury. Bone bruise was significantly correlated with ACL injury, MCL injury and Lateral collateral ligament (LCL) injury. CONCLUSIONS MRI findings of certain pathologies in a painful knee can coexist and significantly correlate with each other, age and sex of the patient.

BACKGROUND External Fixation (EF) and Open Reduction and Internal Fixation (ORIF) have been the traditional surgical modalities for unstable distal radius fractures. The Locking Compression Plates (LCP) acting as "internal external fixators" are particularly valuable in difficult situations of fractures. We undertook a study to evaluate the outcome of unstable distal radius fractures treated with ORIF with LCP versus those treated by ligamentotaxis with external fixators. MATERIALS AND METHODS A comparative study was carried out in a tertiary care centre with 30 cases of unstable distal radius fractures (15 cases in each group). In one group, open reduction and internal fixation with distal radius volar locking compression plate was carried out and in the other group ligamentotaxis with external fixator was done. The patients were treated and followed up over a period of one and a half year between June 2011 to November 2012. The fractures were classified according to AO classification (Arbeitsgemeinschaft für Osteosynthesefragen: German for "Association for the Study of Internal Fixation" or AO). The functional results were evaluated at the end of 6 months according to Demerit point system of Gartland and Werley modified by Sarmiento (1975) and the anatomical results as per Lindstrom criteria (1959) modified by Sarmiento (1980). RESULTS Overall 86.66% (13) cases had good-to-excellent anatomical results in external fixator group as compared to 93.33% (14) cases in LCP group. The functional outcome was excellent in 80% (12) and good in 13.33% (2) cases in external fixator group as compared to 66.66% (10) excellent and 26.66% (4) good in LCP group. CONCLUSION Both open reduction and internal fixation with locking compression plate and ligamentotaxis with external fixators are good treatment modalities for unstable distal radius fractures. However, the choice should be guided by the fracture configuration, surgeons' experience and patient's profile.

Introduction: In 2019-20, the American College of Radiology (ACR) introduced Ovarian-Adnexal Reporting and Data System Magnetic Resonance Imaging (O-RADS MRII). Application of the O-RADS MRI in routine clinical practice can increase lesion characterization accuracy, promote better interdisciplinary communication, and help in personalized patient management of adnexal masses. Aim: To assess the diagnostic performance of the ACR O-RADS MRI scoring system for the predicting malignancy in adnexal mass in routine clinical radiology practice by using histology/ imaging findings during a minimum 4 month follow-up as the reference standard. Materials and Methods: In this single- tertiary center prospective cohort study done in Jorhat Medical College, Assam, 42 patients with 46 adnexal masses who underwent MRI between April 2020 and June 2021 were assessed. The ACR O-RADS MR scores were assigned using the MRI protocol with a dynamic study. Sensitivity, specificity, positive and negative predictive values along with the area under the Receiver Operating Characteristic (ROC) curve were calculated (cut-off score ≥4 was considered malignancy,). Histopathologic diagnosis or >4 months followup imaging findings was the reference standard used. Logistic regression analysis of MRI parameters used in identifying malignant masses was assessed. Statistical analysis was done using 95% confidence intervals (CIs). The p-values <0.05 was considered statistically significant. Results: The mean age of subjects in the study was 35.9 (range 10-75 years), and 84.8% of adnexal masses (39) were premenopausal. Malignancy was more common in postmenopausal patients (57.1%). Of 46 lesions, 13 (33.3%) were malignant. The ACR O-RADS-MR scoring system, using a dynamic MRI protocol, showed 92.3% sensitivity and 87.8%specificity in malignancy prediction. The area under the ROC curve for predicting malignancy was 0.962. The positive and negative predictive values were 75% and 89.1%, respectively. Conclusion: In a teaching hospital in assam, the O-RADS MRI scoring system, based on a dynamic MRI protocol demonstrated good sensitivity, specificity and area under the Receiver Operator Characteristic (ROC) curve in identifying malignant adnexal masses. The ACR O-RADS MRI system enables standardized MRI reporting with uniform lexicon and interpretation guide on adnexal masses.This will help to improve communication between radiologists and referring physician and in patient management, particularly in indeterminate masses on ultrasound.