SA Journal of Radiology - latest Issue
Volume 21, Issue 1, 2017
Source: SA Journal of Radiology 21, pp 1 –8 (2017) http://dx.doi.org/10.4102/sajr.v21i1.1080More Less
Background: Shoulder pain is the most common and well-documented site of musculoskeletal pain in elite swimmers. Structural abnormalities on magnetic resonance imaging (MRI) of elite swimmers’ symptomatic shoulders are common. Little has been documented about the association between MRI findings in the asymptomatic shoulder versus the symptomatic shoulder.
Objective: To assess clinically relevant MRI findings in the shoulders of symptomatic and asymptomatic elite swimmers.
Method: Twenty (aged 16–23 years) elite swimmers completed questionnaires on their swimming training, pain and shoulder function. MRI of both shoulders (n = 40) were performed and all swimmers were given a standardised clinical shoulder examination.
Results: Both shoulders of 11 male and 9 female elite swimmers (n = 40) were examined. Eleven of the 40 shoulders were clinically symptomatic and 29 were asymptomatic. The most common clinical finding in both the symptomatic and asymptomatic shoulders was impingement during internal rotation, with impingement in 54.5% of the symptomatic shoulders and in 31.0% of the asymptomatic shoulders. The most common MRI findings in the symptomatic and asymptomatic shoulders were supraspinatus tendinosis (45.5% vs. 20.7%), subacromial subdeltoid fluid (45.5% vs. 34.5%), increased signal in the AC Joint (45.5% vs. 37.9%) and AC joint arthrosis (36.4% vs. 34.5%). Thirty-nine (97.5%) of the shoulders showed abnormal MRI features.
Conclusion: MRI findings in the symptomatic and asymptomatic shoulders of young elite swimmers are similar and care should be taken when reporting shoulder MRIs in these athletes. Asymptomatic shoulders demonstrate manifold MRI abnormalities that may be radiologically significant but appear not to be clinically significant.
Source: SA Journal of Radiology 21, pp 1 –7 (2017) http://dx.doi.org/10.4102/sajr.v21i1.1099More Less
Background: Fine needle aspiration cytology (FNAC) cannot reliably differentiate follicular adenoma from follicular carcinoma (FC), which requires histological evidence of capsular or vascular invasion. FC is the most predominant thyroid cancer in our loco-regional environment, indicating the need for improvement in preoperative diagnostic accuracy of thyroid nodules to ensure appropriate and timely interventions.
Objective: The purpose of this study was to assess the role of technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) scintigraphy and ultrasonography (USG) in the differential diagnosis of thyroid nodules.
Methods: Forty-two patients with hypofunctioning thyroid nodules were prospectively studied with 99mTc-MIBI scintigraphy and USG to differentiate benign from malignant nodules. An injection of 740 MBq of 99mTc-MIBI was intravenously administered, followed by semiquantitative analysis of dual-phase scans using a 4-point (0 to 3) scoring system. USG was subsequently performed and interpretation was based on some sonographic criteria for malignancy. In the following days and weeks, patients underwent FNAC followed by surgery and histopathologic examination.
Results: All malignant nodules were positive on 99mTc-MIBI and all but two malignant nodules were positive on USG. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy are, respectively, 100%, 70%, 65%, 100%, and 81% for 99mTc-MIBI scintigraphy; 87%, 78%, 68%, 91% and 81% for USG; and 83%, 100%, 100%, 96% and 64% for FNAC. There was no statistically significant difference between 99mTc-MIBI scintigraphy and USG performance for both benign (p = 0.317) and malignant (p = 0.573) nodules.
Conclusion: 99mTc-MIBI scintigraphy and USG are important imaging modalities in the evaluation of thyroid nodules, particularly follicular neoplasms which are frequently associated with non-diagnostic cytology.
Source: SA Journal of Radiology 21, pp 1 –3 (2017) http://dx.doi.org/10.4102/sajr.v21i1.1063More Less
Intussusception happens when a portion of bowel telescopes into the adjacent bowel segment. It is a rare condition in the adult population, particularly in the young adult, and poses a diagnostic dilemma to the attending clinician because of its variable clinical presentation. Radiological imaging is important in the early diagnosis, and it allows prompt surgical management to avoid severe complications, particularly bowel ischaemia and necrosis. This case report describes the clinical and multimodality radiological findings of an ileocolic intussusception secondary to a mucosa-associated lymphoid tissue (MALT) lymphoma in a young adult patient.
Source: SA Journal of Radiology 21, pp 1 –7 (2017) http://dx.doi.org/10.4102/sajr.v21i1.1092More Less
A delegation of the College of Radiologists of the overarching Colleges of Medicine of South Africa observed the spring sitting of the Part 2B Examination of the Fellowship of the Royal College of Radiologists (FRCR) in London, in April 2016. Although the principal focus of the Observership was the Part 2B examination, the delegates also assessed broader aspects of the FRCR. This report presents an overview of current FRCR practices, including the findings of an independent review of the FRCR, and reflects on the implications for the South African Fellowship examination. The report is based on discussions with key Royal College role players, direct observation of the Part 2B examination and web-based documentation. It allows appreciation of the continued close alignment of the FC Rad Diag(SA) (Fellowship of the College of Radiologists of the Colleges of Medicine of South Africa) with the FRCR and highlights expected trends in the FC Rad Diag(SA). It also documents the increasing human resources required for successful conduct of examinations. It is hoped that the report will be of interest and relevance to the broad South African radiological community and to those contemplating specialist training in the discipline. It is trusted that it will encourage wider involvement of radiological and medical physics colleagues in the various FC Rad Diag(SA) examination processes.
Potential pitfalls in the anorectal region during CT colonography : a discussion and pictorial overview of common pitfallsAuthor Joel BortzSource: SA Journal of Radiology 21, pp 1 –11 (2017) http://dx.doi.org/10.4102/sajr.v21i1.1108More Less