Skeletal dysplasias are not uncommon entities and a radiologist is likely to encounter a suspected case of dysplasia in his practice. The correct and early diagnosis of dysplasia is important for management of complic...Skeletal dysplasias are not uncommon entities and a radiologist is likely to encounter a suspected case of dysplasia in his practice. The correct and early diagnosis of dysplasia is important for management of complications and for future genetic counselling. While there is an exhaustive classification system on dysplasias, it is important to be familiar with the radiological features of common dysplasias. In this article, we enumerate a radiographic approach to skeletal dysplasias, describe the essential as well as differentiating features of common non-lethal skeletal dysplasias and conclude by presenting working algorithms to either definitively diagnose a particular dysplasia or suggest the most likely differential diagnoses to the referring clinician and thus direct further workup of the patient.展开更多
Background: Dental and cranio-maxillofacial diagnostic imaging constitutes an invaluable tool in the accurate diagnosis and management of a diverse range of conditions and diseases that afflict the oral and cranio-max...Background: Dental and cranio-maxillofacial diagnostic imaging constitutes an invaluable tool in the accurate diagnosis and management of a diverse range of conditions and diseases that afflict the oral and cranio-maxillofacial region. In order to improve on any existing facility, periodic audit evaluation is paramount. In this way proper and relevant service delivery can be achieved. Objective: To evaluate the range and volume of dental and cranio-maxillofacial diagnostic radiographic services offered at the University of Nairobi Dental Hospital (UNDH) in Kenya over a 5-year period (2006-2010). Methods: Retro-spective survey involving manual examination of patient records at the Division of Dental and cra-nio-maxillofacial Radiology registry of the UNDH. Results: Over the study period, the range of diagnostic radiographic services offered comprised of both intra- and extra- oral examinations. The total volume of radiographs taken was 48,874 among which 41,980 (86%) were intraoral and 6894 (14%) extraoral views. Among the intraoral views, 74% were bitewing, 25% periapical and only 1% were occlusal diagnostic views. The majority (95%) of the extraoral projections consisted of panoramic views and only 5% constituted other techniques. The volume of radiographs was high from January to September while November and December had the lowest number of examination requests. Conclusion: Intraoral radiography was the commonest examination with bitewings having been the majority while the panoramic tomography was the commonest extraoral examination performed.展开更多
AIM To evaluate the association between C-reactive protein(CRP) and radiological evidence of lower respiratory tract infection(LRTI) in infants.METHODS All patients aged less than 4 years who presented with suspected ...AIM To evaluate the association between C-reactive protein(CRP) and radiological evidence of lower respiratory tract infection(LRTI) in infants.METHODS All patients aged less than 4 years who presented with suspected lower respiratory tract infection,who received a peri-presentation chest radiograph and CRP blood measurement over an 18-mo period were included in the study.Age,gender,source of referral,CRP,white cell count,neutrophil count along with the patients' symptoms and radiologist's report were recorded.RESULTS Three hundred and eleven patients met the inclusioncriteria.Abnormal chest radiographs were more common in patients with elevated CRP levels(P < 0.01).Radiologic signs of LRTI were identified in 73.7% of chest radiographs when a patient had a CRP level between 50-99 mg/L.CRP levels were a better predictor of positive chest radiograph findings for those aged greater than I year compared to those 1 year or less.CONCLUSION CRP may be used in patients with suspected LRTI diagnosis to select those who are likely to have positive findings on chest radiograph,thus reducing unnecessary chest radiographs.展开更多
Objective: The work aims to determine the radiographers’ preference between primary and secondary radiation fields for imprinting anatomical markers on radiographs. Methodology: Processed radiographs from the darkroo...Objective: The work aims to determine the radiographers’ preference between primary and secondary radiation fields for imprinting anatomical markers on radiographs. Methodology: Processed radiographs from the darkroom with evidence of radiographic anatomical markings were selected randomly and reviewed using a viewing box, within a 4-week period. The radiation field in which markers were placed was noted for each radiograph. Faintly-appearing and partly coned- off markers were excluded. Simple statistical tools were used to derive central tendency. Result: 623 radiographs were assessed. 89.0% (n = 555) had markers in the primary radiation field while 11.0% (n = 68) were in the secondary radiation field. 98% (n = 611) of markers did not obstruct essential anatomy while 2% (n = 12) did, but the radiographs were neither repeated nor rejected because of the twin reason of reportability and the need to avoid additional radiation dose to patients. Conclusion: Radiographers in the centre preferred the primary radiation field for marker placement to avoid cone-off, cut-off and illegibility which leads to repeat. This, however, does not offer superior advantage to markers placed in secondary radiation field. It is recommended that marker placement preference should be guided by the need for legibility, aesthetics and avoidance of essential anatomy.展开更多
In wrist pathology, there is a need to establish the normal range of radiographic measurement parameters. Previous study showed that the contralateral wrist might not be valid as a reference for all parameters. There ...In wrist pathology, there is a need to establish the normal range of radiographic measurement parameters. Previous study showed that the contralateral wrist might not be valid as a reference for all parameters. There is a lack of literature describing the normal range of wrist radiographic parameters in literature. As a result, a retrospective study was carried out. Patients who underwent standard wrist x-rays during the period February 2012 to February 2013 (one single year) were retrospectively reviewed. 71 patients were included. Scapholunate angle was 54.7° (±6.5°). Scapholunate interval was 2.0 mm (±0.4 mm). Ulnar variance was +1.0 mm (±1.8 mm). Carpal height was 31.8 mm (±3.0 mm). Radial inclination was 25.1° (±2.1°). All 71 patients had 1 sesamoid bone at first metacarpal. 16.9% (12 out of 71) patients had positive cortical ring signs. All these parameters are valuable clinically, especially in monitoring of the wrist disease progression, in the design of wrist implants and for future clinical research.展开更多
Background: Radiographic studies largely contribute to prompt diagnosis of ovarian torsion, though post-operative changes are not described and might contribute to unnecessary intervention. Case: We report a case of o...Background: Radiographic studies largely contribute to prompt diagnosis of ovarian torsion, though post-operative changes are not described and might contribute to unnecessary intervention. Case: We report a case of ovarian torsion diagnosed based on clinical presentation and radiographic findings. The detorsion was successfully performed through laparosopic access. Subsequently patient presented for elective ultrasonography and MRI which diagnosed multicystic ovarian mass, attributed to hematoma which resolved spontaneously with no intervention in 3 weeks. Conclusion: Ovarian changes after detorsion consistent with development of hematoma may be benign and resolve spontaneously.展开更多
Introduction: Fractures of the clavicle are common and make up 5% - 10% of all fractures. Treatment options in part depend on the location of the fracture along the bone and degree of displacement. These two parameter...Introduction: Fractures of the clavicle are common and make up 5% - 10% of all fractures. Treatment options in part depend on the location of the fracture along the bone and degree of displacement. These two parameters are best determined by good quality, standardized radiographs of the clavicle. We reviewed the literature to determine the optimal radiographs of clavicle fractures and their influence on the treatment plan. Methods: A comprehensive search of Medline? database was undertaken with the following search terms and MeSH headings: clavicle, fractures, bone, radiography, and X-ray. We included articles in English published from 1950 to present. We ruled out fractures in children, fracture dislocations, open fractures, those with neurological and vascular injuries and fractures involving the acromioclavicular or sternoclavicular joints. Findings: Of the 821 citations obtained, only four studies proved eligible. In the most pertinent, four orthopaedic surgeons were shown standard views (antero-posterior and 20°cephalic tilt) of 50 clavicle fractures and then additional two views (45°cephalic and caudal tilt), and found that alternative views influenced their decision making, with more surgeons opting for surgical fixation. In a different study, it was shown that orthogonal views of the clavicle increased surgeons’ understanding and improved their treatment of these fractures. The third paper was a case series on clavicle fractures that were missed on the initial antero-posterior radiograph, and the fourth paper postulated that postero-anterior views of the thorax were most accurate in determining length of the clavicle. Conclusion: Studies showing an optimal view for assessment of clavicle fractures with a decision to then progressing to operative fixation are few, but the evidence points towards surgical fixation when alternative views of mid-shaft clavicle fractures are present.展开更多
Background: There are associations between the severity of periodontal diseases and some predisposing factors, such as age, race, and income rate. Therefore, the present study was designed to evaluate the extra-oral d...Background: There are associations between the severity of periodontal diseases and some predisposing factors, such as age, race, and income rate. Therefore, the present study was designed to evaluate the extra-oral digital panoramic radiographic interpretation and clinical findings of stage IV periodontitis among some samples concerning Saudi/non-Saudi nationality. Material and Methods: The study comprised a random sample of 298 residents in Saudi Arabia referred to the internship program clinics at the College of Dentistry, King Khalid University. They were according to the age of participants as follows: youth (15 - 24 years), adults (25 - 64 years), and seniors (65 years and over) within two groups according to nationality (Saudi and non-Saudi). Clinical periodontal examination and radiographic extra oral digital panoramic radiographs were done, and then the periodontal parameters, the percentage of bone loss, and the pattern of bone loss were recorded. The data was collected, and the statistical analysis was performed with ANOVA test, Tukey’s test, Chi-square test, and T-test and considered a P-value at (p Results: The samples included 62 (20%) youth participants with mean of age (21.806 ± 3.390), 182 (57%) adults’ participants with mean age (42.802 ± 9.094), and 54 (23%) seniors participants with a mean age (69.074 ± 6.810). There were highly statistically significant differences in the comparison between the participants’ ages (P 0.05). Conclusion: At the end of this study, we concluded that there are alterations in clinical and radiographic and clinical findings of stage IV periodontitis with the alteration of participants’ ages and nationality.展开更多
Most of the foreign bodies detected in adult gastroin- testinal systems are accidentally swallowed pins. In this study, we presented a case with intracolonic multiple pebbles. A 20-year-old man was admitted to emergen...Most of the foreign bodies detected in adult gastroin- testinal systems are accidentally swallowed pins. In this study, we presented a case with intracolonic multiple pebbles. A 20-year-old man was admitted to emergency surgery policlinic for abdominal pain for 2 d without any alleviation or aggravation. His upright plain abdominal radiographic imaging revealed about 30-40 overt dense opacities in lumen of colonic segments, with oval and well shaped contours, each approximately 1 cm x 1 cm in size. The multiplanar reconstructions and three- dimensional images combined with sectional screening showed that all pebbles had passed completely into the colon and no foreign bodies had remained in the ileal segments. On psychiatric assessment, he was found to have immature personality features, difficulty in over- coming stressors and adaptation disorder. He recovered by conservative management and radiographic monitor- ing applied during his follow-up. Thus, it can be con- cluded that, in differential diagnosis of abdominal pain in adult ages, though less frequently seen than in children, gastrointestinal system foreign bodies should always be kept in mind and it should be considered that ingestion of pebbles may be one of the factors contributing to ab- dominal pain particularly in young adults with psychiatric problems. In such cases suspected of having foreign bodies which cannot be detected by plain f ilms, abdominal tomography can be an alternative for diagnostic imaging.展开更多
With extended and continued expansion of medical imaging utilization in modern medical practice over last decade, radiologists as well as other faculty staff dealing with radiographic and magnetic resonances contrast ...With extended and continued expansion of medical imaging utilization in modern medical practice over last decade, radiologists as well as other faculty staff dealing with radiographic and magnetic resonances contrast media(CM) have to be well oriented with their potential hypersensitivity reactions and recognize high-risk groups liable to develop it so as to enable early recognition. Radiologists and other medical staff involved in administration and dealing with CM have to be ready to implement prompt, practical and effective management plan to deal with these scenarios should they emerge. Strategies to prevent potential contrastinduced acute and delayed renal injuries have to be routinely exercised. Paying attention to the pregnant and nursing women, pediatrics, diabetics, as well as other fragile populations is of utmost importance for patient safety during contrast administrations. Radiologists should play a pivotal role in orienting patients about necessity to use CM for their imaging studies, in case it is needed, and assure them about its safety. Moreover, they have to be oriented with the medico-legal issues related to use of CM. These will pay as improved patient safety as well as safe daily working environmentat different levels of radiology practices.展开更多
文摘Skeletal dysplasias are not uncommon entities and a radiologist is likely to encounter a suspected case of dysplasia in his practice. The correct and early diagnosis of dysplasia is important for management of complications and for future genetic counselling. While there is an exhaustive classification system on dysplasias, it is important to be familiar with the radiological features of common dysplasias. In this article, we enumerate a radiographic approach to skeletal dysplasias, describe the essential as well as differentiating features of common non-lethal skeletal dysplasias and conclude by presenting working algorithms to either definitively diagnose a particular dysplasia or suggest the most likely differential diagnoses to the referring clinician and thus direct further workup of the patient.
文摘Background: Dental and cranio-maxillofacial diagnostic imaging constitutes an invaluable tool in the accurate diagnosis and management of a diverse range of conditions and diseases that afflict the oral and cranio-maxillofacial region. In order to improve on any existing facility, periodic audit evaluation is paramount. In this way proper and relevant service delivery can be achieved. Objective: To evaluate the range and volume of dental and cranio-maxillofacial diagnostic radiographic services offered at the University of Nairobi Dental Hospital (UNDH) in Kenya over a 5-year period (2006-2010). Methods: Retro-spective survey involving manual examination of patient records at the Division of Dental and cra-nio-maxillofacial Radiology registry of the UNDH. Results: Over the study period, the range of diagnostic radiographic services offered comprised of both intra- and extra- oral examinations. The total volume of radiographs taken was 48,874 among which 41,980 (86%) were intraoral and 6894 (14%) extraoral views. Among the intraoral views, 74% were bitewing, 25% periapical and only 1% were occlusal diagnostic views. The majority (95%) of the extraoral projections consisted of panoramic views and only 5% constituted other techniques. The volume of radiographs was high from January to September while November and December had the lowest number of examination requests. Conclusion: Intraoral radiography was the commonest examination with bitewings having been the majority while the panoramic tomography was the commonest extraoral examination performed.
文摘AIM To evaluate the association between C-reactive protein(CRP) and radiological evidence of lower respiratory tract infection(LRTI) in infants.METHODS All patients aged less than 4 years who presented with suspected lower respiratory tract infection,who received a peri-presentation chest radiograph and CRP blood measurement over an 18-mo period were included in the study.Age,gender,source of referral,CRP,white cell count,neutrophil count along with the patients' symptoms and radiologist's report were recorded.RESULTS Three hundred and eleven patients met the inclusioncriteria.Abnormal chest radiographs were more common in patients with elevated CRP levels(P < 0.01).Radiologic signs of LRTI were identified in 73.7% of chest radiographs when a patient had a CRP level between 50-99 mg/L.CRP levels were a better predictor of positive chest radiograph findings for those aged greater than I year compared to those 1 year or less.CONCLUSION CRP may be used in patients with suspected LRTI diagnosis to select those who are likely to have positive findings on chest radiograph,thus reducing unnecessary chest radiographs.
文摘Objective: The work aims to determine the radiographers’ preference between primary and secondary radiation fields for imprinting anatomical markers on radiographs. Methodology: Processed radiographs from the darkroom with evidence of radiographic anatomical markings were selected randomly and reviewed using a viewing box, within a 4-week period. The radiation field in which markers were placed was noted for each radiograph. Faintly-appearing and partly coned- off markers were excluded. Simple statistical tools were used to derive central tendency. Result: 623 radiographs were assessed. 89.0% (n = 555) had markers in the primary radiation field while 11.0% (n = 68) were in the secondary radiation field. 98% (n = 611) of markers did not obstruct essential anatomy while 2% (n = 12) did, but the radiographs were neither repeated nor rejected because of the twin reason of reportability and the need to avoid additional radiation dose to patients. Conclusion: Radiographers in the centre preferred the primary radiation field for marker placement to avoid cone-off, cut-off and illegibility which leads to repeat. This, however, does not offer superior advantage to markers placed in secondary radiation field. It is recommended that marker placement preference should be guided by the need for legibility, aesthetics and avoidance of essential anatomy.
文摘In wrist pathology, there is a need to establish the normal range of radiographic measurement parameters. Previous study showed that the contralateral wrist might not be valid as a reference for all parameters. There is a lack of literature describing the normal range of wrist radiographic parameters in literature. As a result, a retrospective study was carried out. Patients who underwent standard wrist x-rays during the period February 2012 to February 2013 (one single year) were retrospectively reviewed. 71 patients were included. Scapholunate angle was 54.7° (±6.5°). Scapholunate interval was 2.0 mm (±0.4 mm). Ulnar variance was +1.0 mm (±1.8 mm). Carpal height was 31.8 mm (±3.0 mm). Radial inclination was 25.1° (±2.1°). All 71 patients had 1 sesamoid bone at first metacarpal. 16.9% (12 out of 71) patients had positive cortical ring signs. All these parameters are valuable clinically, especially in monitoring of the wrist disease progression, in the design of wrist implants and for future clinical research.
文摘Background: Radiographic studies largely contribute to prompt diagnosis of ovarian torsion, though post-operative changes are not described and might contribute to unnecessary intervention. Case: We report a case of ovarian torsion diagnosed based on clinical presentation and radiographic findings. The detorsion was successfully performed through laparosopic access. Subsequently patient presented for elective ultrasonography and MRI which diagnosed multicystic ovarian mass, attributed to hematoma which resolved spontaneously with no intervention in 3 weeks. Conclusion: Ovarian changes after detorsion consistent with development of hematoma may be benign and resolve spontaneously.
文摘Introduction: Fractures of the clavicle are common and make up 5% - 10% of all fractures. Treatment options in part depend on the location of the fracture along the bone and degree of displacement. These two parameters are best determined by good quality, standardized radiographs of the clavicle. We reviewed the literature to determine the optimal radiographs of clavicle fractures and their influence on the treatment plan. Methods: A comprehensive search of Medline? database was undertaken with the following search terms and MeSH headings: clavicle, fractures, bone, radiography, and X-ray. We included articles in English published from 1950 to present. We ruled out fractures in children, fracture dislocations, open fractures, those with neurological and vascular injuries and fractures involving the acromioclavicular or sternoclavicular joints. Findings: Of the 821 citations obtained, only four studies proved eligible. In the most pertinent, four orthopaedic surgeons were shown standard views (antero-posterior and 20°cephalic tilt) of 50 clavicle fractures and then additional two views (45°cephalic and caudal tilt), and found that alternative views influenced their decision making, with more surgeons opting for surgical fixation. In a different study, it was shown that orthogonal views of the clavicle increased surgeons’ understanding and improved their treatment of these fractures. The third paper was a case series on clavicle fractures that were missed on the initial antero-posterior radiograph, and the fourth paper postulated that postero-anterior views of the thorax were most accurate in determining length of the clavicle. Conclusion: Studies showing an optimal view for assessment of clavicle fractures with a decision to then progressing to operative fixation are few, but the evidence points towards surgical fixation when alternative views of mid-shaft clavicle fractures are present.
文摘Background: There are associations between the severity of periodontal diseases and some predisposing factors, such as age, race, and income rate. Therefore, the present study was designed to evaluate the extra-oral digital panoramic radiographic interpretation and clinical findings of stage IV periodontitis among some samples concerning Saudi/non-Saudi nationality. Material and Methods: The study comprised a random sample of 298 residents in Saudi Arabia referred to the internship program clinics at the College of Dentistry, King Khalid University. They were according to the age of participants as follows: youth (15 - 24 years), adults (25 - 64 years), and seniors (65 years and over) within two groups according to nationality (Saudi and non-Saudi). Clinical periodontal examination and radiographic extra oral digital panoramic radiographs were done, and then the periodontal parameters, the percentage of bone loss, and the pattern of bone loss were recorded. The data was collected, and the statistical analysis was performed with ANOVA test, Tukey’s test, Chi-square test, and T-test and considered a P-value at (p Results: The samples included 62 (20%) youth participants with mean of age (21.806 ± 3.390), 182 (57%) adults’ participants with mean age (42.802 ± 9.094), and 54 (23%) seniors participants with a mean age (69.074 ± 6.810). There were highly statistically significant differences in the comparison between the participants’ ages (P 0.05). Conclusion: At the end of this study, we concluded that there are alterations in clinical and radiographic and clinical findings of stage IV periodontitis with the alteration of participants’ ages and nationality.
文摘Most of the foreign bodies detected in adult gastroin- testinal systems are accidentally swallowed pins. In this study, we presented a case with intracolonic multiple pebbles. A 20-year-old man was admitted to emergency surgery policlinic for abdominal pain for 2 d without any alleviation or aggravation. His upright plain abdominal radiographic imaging revealed about 30-40 overt dense opacities in lumen of colonic segments, with oval and well shaped contours, each approximately 1 cm x 1 cm in size. The multiplanar reconstructions and three- dimensional images combined with sectional screening showed that all pebbles had passed completely into the colon and no foreign bodies had remained in the ileal segments. On psychiatric assessment, he was found to have immature personality features, difficulty in over- coming stressors and adaptation disorder. He recovered by conservative management and radiographic monitor- ing applied during his follow-up. Thus, it can be con- cluded that, in differential diagnosis of abdominal pain in adult ages, though less frequently seen than in children, gastrointestinal system foreign bodies should always be kept in mind and it should be considered that ingestion of pebbles may be one of the factors contributing to ab- dominal pain particularly in young adults with psychiatric problems. In such cases suspected of having foreign bodies which cannot be detected by plain f ilms, abdominal tomography can be an alternative for diagnostic imaging.
文摘With extended and continued expansion of medical imaging utilization in modern medical practice over last decade, radiologists as well as other faculty staff dealing with radiographic and magnetic resonances contrast media(CM) have to be well oriented with their potential hypersensitivity reactions and recognize high-risk groups liable to develop it so as to enable early recognition. Radiologists and other medical staff involved in administration and dealing with CM have to be ready to implement prompt, practical and effective management plan to deal with these scenarios should they emerge. Strategies to prevent potential contrastinduced acute and delayed renal injuries have to be routinely exercised. Paying attention to the pregnant and nursing women, pediatrics, diabetics, as well as other fragile populations is of utmost importance for patient safety during contrast administrations. Radiologists should play a pivotal role in orienting patients about necessity to use CM for their imaging studies, in case it is needed, and assure them about its safety. Moreover, they have to be oriented with the medico-legal issues related to use of CM. These will pay as improved patient safety as well as safe daily working environmentat different levels of radiology practices.
