Aims and objectives:To evaluate the role of magnetic resonance imaging (MRI) as a non-invasive diagnostic tool in patients with acute and chronic spinal trauma and to compare and correlate the MRI findings with those of patients’ clinical profile and neurological outcome according to ASIA impairment scale to assess prognostic and clinical value of MRI.Materials and Methods:Sixty two patients of spinal trauma formed the study group in a prospective fashion. The patients undergoing MR imaging and magnetic resonance images were analyzed and correlated with findings on neurological examination according to American Spinal Injury Association (ASIA) impairment scale (AIS) at the time of MRI examination and subsequently at sub-acute interval to assess neurological outcome.Statistical Analysis:Sample profile was described in terms of 95% confidence limit and proportion. To describe strength of association between extent of spinal cord injury and outcome, odd's ratio, bivariate and multi variant analysis, was used. Pearson's chi square (χ) 2 statistics was applied to test the association between two categorical variables. Data were analyzed using statistical software package, STATA 9.2 and the difference was considered to be significant if ‘P’ value was <0.05.Observation and Results:The cord edema without hemorrhage was the most common MR finding (41.5%). The others were sizable focus of hemorrhage within the cord (33%), epidural hematoma (5.0%), and normal cord (26%). Majority of MR findings correlated well with clinical profile of the patient according to ASIA impairment scale. This study demonstrated that patients with presence of sizable focus of haemorrhage had larger cord edema and more severe grade of initial ASIA impairment scale( AIS) with poor recovery at follow up (P=0.032).Improvement in upper extremity was more than lower extremity. Severe cord compression was also associated with poor neurological outcome; however it was not statistically significant (P=0.149).Conclusions:With this study the authors concluded that various MRI findings in acute spinal cord injury correlated well with the initial clinical findings and on follow-up according to ASIA impairment scale. MRI is useful for initial diagnosis of acute spinal cord injury and its prognostication for predicting neurological recovery.

Fetus-in-fetu (FIF) is a rare anomaly in which a vertebrate fetus is enclosed within the body of its twin in diamniotic monochorionic pregnancy. To the best of our knowledge, fewer than 100 cases have been reported in literature. Although a wide variety of presentations have been described in clinical reports, the characteristic features on MRI which distinguish FIF from teratoma have not been well delineated. Here we present a case of fetus-in-fetu in which characteristic MDCT and MR findings were used to diagnose FIF preoperatively and successfully differentiate it from teratoma. Although both CT and MRI can be used for definitive preoperative diagnosis of FIF, MRI is an ideal imaging modality due to inherent high tissue contrast and spatial resolution. Furthermore, MRI obviates the need for iodine contrast and eliminates the risk of ionizing radiation. We emphasize that MRI is an ideal valuable diagnostic tool for definite preoperative diagnosis of FIF and surgical planning.

Emphysematous osteomyelitis is a rare condition characterized by the presence of intraosseous gas. A prompt diagnosis is required for this disease to expedite management as it is a potentially fatal condition. Many comorbidities, such as malignancy, diabetes mellitus, alcohol abuse, Crohn's disease, and other etiologies causing immunosuppression, predispose to this condition. The causative organisms are generally anaerobes or members of Enterobacteriaceae family; however, the infection can be mono or polymicrobial. We report two cases affected with emphysematous osteomyelitis due to varied underlying comorbidities. The purpose of this study is to (a) emphasize the importance of computed tomography in diagnosing emphysematous osteomyelitis and (b) to highlight an unusual location of this rare pathology.

Zinner syndrome is a rare developmental anomaly of the Wolffian (mesonephric) duct which is characterised by a triad of obstruction of the ejaculatory duct, the ipsilateral seminal vesicle cyst, and the ipsilateral renal agenesis. The aim of this case report is to emphasize the importance of radiological imaging in diagnosing the condition and to report its rare unusual variant.

Objective: To evaluate the usefulness of Color Doppler flowmetry in the prediction of intrauterine growth restriction (IUGR) in high-risk pregnancies.Materials and method: A total of 62 high-risk pregnant women underwent Color Doppler flowmetric umbilical artery pulsatility index (PI), resistive index (RI) and systolic/diastolic (S/D) ratio, middle cerebral artery PI, RI and S/D ratio, Ductus venosus S-wave/isovolumetric A-wave index (SIA) and vertebral artery RI at 23-27 weeks, 28-32 weeks and 32-36 weeks of their pregnancy. Cerebral-umbilical C/U PI, RI and S/D were evaluated at the third visit. All the pregnancies were followed up till delivery. Ponderal index <10 was considered to be indicative of IUGR. Data were analyzed using IBM Statistical Package for Social Sciences (SPSS) 21.0.Results: Thirty-nine (62.9%) deliveries were IUGR. On all the three visits, umbilical artery, mean PI, RI and SD values were significantly higher while MCA PI, RI and SD values were significantly lower in IUGR as compared to non-IUGR cases. Third visit C/U PI, RI and SD ratio values were also significantly lower in IUGR as compared to non-IUGR cases. Ductus venosus SIA values did not show a significant difference between IUGR and non-IUGR groups. The vertebral artery resistive index was significantly higher in non-IUGR as compared to IUGR on all the visits. Umbilical artery PI was the most sensitive and specific for the prediction of IUGR at all the three visits, with the maximum sensitivity and specificity at the third visit (82.1% and 87%). Third visit C/U PI was most sensitive (82.1%) and specific (96.7%) for the prediction of IUGR.Conclusion: This showed that Doppler flowmetry is a useful method for the prediction of IUGR in high-risk pregnancies.

Macrodystrophia lipomatosa (MDL) is a rare cause of congenital macrodactyly, characterised by progressive proliferation of all mesenchymal elements, with disproportionate increase in fibro-adipose tissue. It occurs most frequently in lower limbs along the distribution of the medial plantar nerve. MDL presents as localised gigantism of the hand or foot and comes to clinical attention for cosmetic reasons, mechanical problems secondary to degenerative joint disease, or development of neurovascular compression. Here, we report a case of MDL, with altered soft tissue growth due to an earlier surgery, making clinical diagnosis difficult. However, with a complete radio-clinical work-up and review of the history, a provisional diagnosis of MDL was made, which was confirmed by histopathology and during surgery.

Background and Objectives Intrauterine growth restriction is associated with increased perinatal mortality and morbidity, possibly extending also in adult life, as compared to fetuses and newborns presenting characteristics of normal growth. The present study had been planned to measure the pulsatility index (PI) and resistive index of the middle cerebral artery with pulsatility and resistive index of the umbilical artery in predicting fetal growth restriction. Materials and Methods A total of 60 pregnant women with a clinical history and grayscale-screened patients were taken for Doppler analysis, and a final comparison of accuracy of Doppler indices was done with perinatal outcome. Statistical Analysis The statistical analysis was done using the Statistical Package for Social Sciences version 15.0 statistical analysis software. The values were represented in number (%) and mean ± SD. Observation and Results The umbilical artery PI had maximum sensitivity at the third visit (32-37 weeks) and maximum specificity also at the third visit (32-37 weeks). The umbilical artery resistive index had maximum sensitivity at the second visit (28-32 weeks) and maximum specificity at the third visit (32-37 weeks). The MCA PI had an overall diagnostic accuracy of 52.8 %. Conclusion The PI of the umbilical artery was more sensitive than the PI of the middle cerebral artery. Umbilical artery PI has the maximum overall diagnostic accuracy of 75 %.

Ascariasis of the gallbladder is a very rare presentation. We report a case of a 15-year-old boy who presented with complaints of pain in the abdomen, vomiting, pruritus, and fever on-and-off for 10 days. On radiological examination, an ultrasonography of the abdomen showed a dilated gallbladder with multiple linear echogenic, tubular, parallel lines inside the lumen of the gallbladder, common bile duct and intrahepatic biliary radicles. The zigzag and coiling movement of a worm was noted in the lumen of the gallbladder on real time B-mode ultrasonography. The patient was successfully treated with an anthelminthic drug. On follow up no evidence of the worm was noted in the gallbladder or common bile duct lumen.