Background: Myelopathy is a disease of spinal cord which can lead to significant neurological morbidity. MRI because of better soft tissue differentiation, not only helps in determining the cause of myelopathy but also plays significant role in their management.. Subjects and Methods: A cross sectional study was done on 80 patients in our institute between June 2017 to October 2018. All patients having complaints of pain in the back with sensory or motor dysfunction or both, having suspicion of myelopathy, referred to the department of Radio-diagnosis for MRI spine evaluation. MRI scan performed on 1.5 Tesla PHILIPS ACHIEVA machine, standard surface & body coils were used for acquisition of images. Results: In this study out of 80 patients of myelopathy, 65% were due to cord compression and 35% were due to non compressive causes. Involvement of cervical spine was more common than the thoraco-lumbar spine. Most common condition associated with compression of the cord was Degenerative spine disease followed by Potts spine and trauma. Under the causes of Non compressive myelopathy-Myelitis was the most common cause, which was seen most in Isolated cases followed by associations with Multiple sclerosis and Neuromyelitis optica. Conclusion: MRI is the mainstay modality to diagnose spinal cord pathologies. Degenerative spine disease was the most common cause of compressive myelopathy and Myelitis was the most common cause of Non compressive myelopathy. Early diagnosis using MRI improves the prognosis of myelopathy.
Introduction: CT urography is an imaging technique in which the i.v contrast is injected and phases of CT scan are taken to study the entire urinary system. It has essentially replaced intravenous urography (IVU) in most imaging practices. CT Urography has evolved as an ideal imaging tool for comprehensive imaging assessment of patients with flank pain, malignancies, hematuria, trauma, renal calculi, suspected congenital malformations and in various clinical settings. Other CT advantages include the use of multiplanar reconstruction (MPR), curved planar reformatted images, maximum intensity projection (MIP) and three-dimensional (3D) reconstruction which gives valuable information to the clinician about the extent of the lesions and helps in management. Aim: To study various types of ureteric abnormalities in CT Urography in various clinical presentation. Materials and methods: This is a tertiary hospital based observational Descriptive Cross sectional study conducted on 360 patients referred for CT Urography with Clinical Signs & Symptoms of urinary tract abnormalities, having ureteric imaging abnormalities. Siemens somatum High Definition 128 slice CT scanner was used for single bolus CT urography. Results: Males were more as compared to females with age group 31 to 50 years (44.4%). Abdominal pain with urinary complaints was seen in maximum number of patients (203 cases- 56.4%). Urinary complaints in known abdomino-pelvic malignancies was seen in 18% cases. 285 patients had obstructive urography findings like hydronephrosis or hydroureter, and 75 cases had non obstructive findings like ureteral filling defects due to calculi, clots, etc or abnormal ureteric course or only congenital abnormality. Most hydroureter cases were secondary to obstructive calculus followed by obstruction by external malignant mass. Conclusion: This study outlines the most common ureteric abnormalities in patients referred for CT urography which were mostly obstructive findings most cases were secondary to obstructive calculus followed by obstruction by external malignant mass. The non obstructive findings like ureteral filling defects were due to calculi, clots, etc or abnormal ureteric course or only congenital abnormalities. Delayed phase of CT urography can also be applied in Contrast CT study of abdomen & Pelvic scans on case to case basis to study ureteric involvements & pathologies.
BACKGROUNDVolvulus of wandering spleen is a rare clinical occurrence with fewer than 500 cases reported and an incidence of less than 0.2%. We present a case of a 27-year-old man, who complained of a short history of severe abdominal pain with the background of recurrent abdominal pain. Ultrasound revealed wandering spleen with splenic vein thrombosis. An abdominal contrast enhanced computerized tomography scan revealed a torted wandering spleen with splenic vein thrombosis with infarction. This required a splenectomy due to splenic infarction. This report highlights the investigations including USG and CECT necessary for a patient who presents with an ischaemic torted wandering spleen.
Central pontine myelinolysis is an acquired demyelinating disease. It is commonly associated with chronic alcoholics, electrolyte imbalance and chronically debilitated patients. It has predilection for involvement of central portion of basis pontis; however, it may involve axons in the putamina, caudate nuclei, thalami, cerebellum, splenium of the corpus callosum and subcortical white matter. [1] The term "osmotic demyelination syndrome" is similar to "central pontine myelinolysis," but also includes areas outside the pons. [2] It is characterised by loss of myelin and oligodendroglia with relative neuron sparing.
The vitellointestinal/omphalomesenteric duct is embryonic structure connecting primary yolk sac to the embryonic midgut which obliterates by 10th week of gestation. It may persist or incompletely obliterate to form anomalies like Meckel’s diverticulum that is most common and is usually asymptomatic. Symptoms develop when Meckel’s diverticulum involves complications such as hemorrhage, inflammation, and perforation, or when it causes intussusception or bowel obstruction. The modalities useful in diagnosing it are ultrasonography (USG) and computed tomography (CT), USG being more easily available, and radiation free is the first modality useful to suspect these anomalies. It can mimic close differentials such as appendicitis and urachal anomalies. In this case report, a 12-year-old male child presented with recurrent periumbilical pain who was screened on USG was suspected Meckel’s diverticulitis with abscess; the same was confirmed on contrast CT scan and managed surgically. This case shows the importance of USG and radiologist’s suspicion of Vitellointestinal duct anomalies in diagnosing and its associated complications.
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