Search

Objective: To determine the frequency of positive CT scan findings in cases of minor head injury with GCS score of 13-15 at presentation based on NICE guideline. Study Design: Cross sectional study Place and Duration of Study: Study was conducted in departments of Radiology CMH Rawalpindi and MH Rawalpindi from 10th Feb 2010 to 10th Aug 2010. Subjects and Methods: One hundred and thirty five indoor and outdoor cases, fulfilling the inclusion criteria, reporting to the radiology department after head trauma, were included in the study after seeking written informed consent. Computerized tomography (CT scan) of the brain was done. Positive CT scan findings i.e. fracture, extradural, subdural and intraparenchymal hemorrhage were noted. Results: Total number of patients studied in this study was 135 and evaluated after taking written consent from them. Out of total 135 patients 104 (77%) were males and 31(23%) were females. Positive CT scan findings were found in 10(7.4%) patients while 125(95.6%) patients had negative CT findings. Among patients having positive CT scan findings epidural hemorrhage was found in 2 (1.5%), intraparenchymal hemorrhage with fracture in 3 (2.2%), skull fracture in 3 (2.2%) and 1 (0.7%) patient had subdural hemorrhage. Conclusion: CT scan is done in minor head trauma although results are often normal. NICE clinical guideline helps in identification and early management of head injury. The goal of implementing such guideline is to do CT scan only in those who are at risk of developing complications, thus minimizing the cost of CT scanning as well as strain on emergency neurology and radiology departments. [ABSTRACT FROM AUTHOR]

Objective: To determine the sensitivity and specificity of the pulsatile index in umbilical artery (PI-UA) and pulsatile index in middle cerebral artery (PI-MCA) in detecting IUGR by comparing it with the birth weight. Study Design: Validation study. Place and Duration of Study: Study was conducted in Department of Radiology, Military Hospital and Combined Military Hospital Rawalpindi, which was equipped with the (Aloka SSD-5500) using 3.5 MHz transducer after seeking permission from hospital ethical committee from 1st January 2010 to 10th July 2010. Subjects and Methods: Two hundred and fifty pregnant women with IUGR in third trimester were included in the study. Ultrasound estimation of fetal weight (using fetal biometry) below 10th percentile for that gestational age was labeled as IUGR. PI-MCA value of less than 11 was labeled as abnormal. PI-UA value of more than 1.451 was labeled as abnormal. Birth weight was taken as gold standard. Results: Sensitivity of PI-UA and PI-MCA were 94.8% and 79.8%, respectively. Specificity of PI-UA and PI-MCA were 36.8% and 90.7%, respectively. Conclusion: Raised PI value of UA is highly sensitive of IUGR; lower PI value of MCA is highly specific of IUGR and grave sign of fetal demise. [ABSTRACT FROM AUTHOR]

Objectives: To determine the association between length of transverse process of seventh cervical vertebrae on plain x-ray cervical spine AP-view and nerve conduction studies of respective patients having brachialgia., Methods: The study was carried out at Department of Radiology, Military Hospital Rawalpindi in collaboration with Armed Forces Institute of Rehabilitation Medicine (AFIRM) Rawalpindi from January 2004 to December 2004. A total of 160 adult subjects were enrolled in this study including 80 volunteers with no history of brachialgia. Eighty subjects suffered from brachialgia and were documented to have abnormal nerve conduction studies/Electromyography referred from AFIRM Rawalpindi. X-ray cervical spine AP-view of all patients was taken. Relative risk (RR) was calculated to determine the association., Results: Eighty percent (64 out of 80) patients with brachialgia and documented abnormal nerve conduction studies had prominent transverse process of seventh cervical vertebrae on x-ray cervical spine AP-view. RR for developing brachialgia was 2.64 and association was statistically significant., Conclusion: X-ray cervical spine AP-view is a simple, quick and tolerable method of measuring transverse process of seventh cervical vertebra. This can predict which individuals are more likely to develop brachialgia.

Background: Magnetic Resonance Imaging (MRI) is frequently advised to evaluate clinically suspected cases of meniscal injuries in our setup. The objective was to determine the diagnostic accuracy of MRI in meniscal injuries of knee joint and its effectiveness in selection of patients for arthroscopy., Methods: A Cross-sectional comparative study was conducted at Radiology Department Military Hospital (MH) Rawalpindi in collaboration with Orthopaedic Department Combined Military Hospital (CMH) Rawalpindi from 31 Jan 2007 to 1 Aug 2007. Fifty-seven patients with clinical suspicion of meniscal injuries were subjected to MRI. Arthroscopy was done only in 34 patients while 23 were excluded on the basis of MRI findings. MRI findings were compared with arthroscopic findings. Medial and lateral menisci were considered separately in each case., Results: Among 57 patients only 30 showed significant tear on MRI. Arthroscopy was done in these cases. Arthroscopy was considered on clinical grounds only in 4 patients who did not show significant tear on MRI. MRI showed Medial Meniscus (MM) injury in 23 patients and Lateral Meniscus (LM) injury in 10 patients. Arthroscopy confirmed MM injury in 17 patients and LM injury in 7 patients. MRI missed two MM and one LM injuries. This showed that MRI has sensitivity of 89.4% and specificity of 62% in diagnosing injuries of MM, while sensitivity of 87% and specificity of 88% in diagnosing injuries of LM. Diagnostic accuracy of MRI in MM and LM injuries was 76.4% and 88.2% respectively., Conclusion: MRI is accurate in diagnosing meniscal injuries of knee joint and is effective in selection of patients for arthroscopy.