SA Journal of Radiology - Volume 11, Issue 2, 2007
Volume 11, Issue 2, 2007
Accuracy of bone assessments for verifying age in adolescents - application in sport : original articleSource: SA Journal of Radiology 11, pp 4 –7 (2007)More Less
Background. Cheating often occurs in sports that are defined by age when older participants compete by falsifying their true age. In some cases administrators have responded by implementing a programme that attempts to establish true age by measuring the skeletal age of competitors. However, because the technique has not been validated in this context there is a risk that competitors who are the correct age may have been unfairly excluded from competition based on these tests.
Objective. To determine whether this technique has sufficient precision to be used effectively to identify 'age cheats'.
Methods. Twenty-three males (14 - 18 years) volunteered for the study. Their skeletal age was determined by means of an X-ray assessment of the hand and wrist undertaken by nine experienced radiologists.
Results. The coefficient of variation of skeletal age for each subject predicted by the different radiologists ranged from 0% to 3.8%. The average difference between the chronological and skeletal ages was -0.5 years (95% confidence interval: -0.9 - -0.1 years), with a maximum under-prediction of 2.4 years and maximum over-prediction of 0.9 years. The magnitude of the error in the prediction did not seem to be related to either the mass or stature percentile of the subjects.
Conclusion. The technique of assessing skeletal age in an attempt to identify sports participants who are older than the prescribed age limit lacks the necessary precision. Until such time as an objective biological method is available to predict age more accurately, sport administrators should rather develop structures that can verify the accuracy of birth certificates.
Bronchial artery embolisation for the treatment of massive haemoptysis resulting from pulmonary tuberculosis : original articleSource: SA Journal of Radiology 11, pp 8 –12 (2007)More Less
Objectives. To report our experience with bronchial artery embolisation (BAE) for the treatment of massive haemoptysis due to untreated or partially treated pulmonary tuberculosis.
Materials and methods. In February 2007 five male patients, between the ages of 40 and 51, presented to Chris Hani Baragwanath Hospital (CHBH) with massive haemoptysis. Bronchial arteriography and embolisation were performed using a 4 French C2 catheter and polyvinyl alcohol (PVA) particles ranging from 300 to 900 micrometers.
Results. Seven bronchial arteries in total were embolised (2 patients required embolisation of 2 arteries each). The haemoptysis was controlled during the first endovascular treatment session in all 5 patients. No serious complications developed in any of our patients as a result of the interventions. At the 1-month follow-up none of the patients had reported any episodes of haemoptysis.
Conclusion. Massive haemoptysis due to pulmonary tuberculosis can be effectively treated with BAE when in a controlled environment, with the proper patient selection and with the appropriate expertise.
Comparison of barium and gastrograffin swallow for radiation therapy planning in carcinoma of the oesophagus : original articleSource: SA Journal of Radiology 11, pp 14 –16 (2007)More Less
Background. Simulation of patients with carcinoma of the oesophagus using radio-opaque contrast is a standard step in treatment planning prior to delivering radiation therapy. Various contrast mediums such as barium, gastrograffin and hexabrix have been used for simulation at different centres.
Objective. The purpose of the study was to compare barium and gastrograffin as a useful and cost-effective contrast medium in simulation for delineation of site and length of the lesion.
Materials and methods. Fifteen patients accepted for radiation therapy underwent simulation using oral barium and gastrograffin swallows prior to treatment. The amount of contrast material used was recorded for both the procedures. The X-rays were taken with both contrast agents keeping the same exposure factors.
Results. The mean amount of barium used was 14 ml (range 10 - 20 ml) as compared to 27.66 ml of gastrograffin (range 10 - 70 ml). The mean cost per patient was R4.40 for barium as against R70.80 for gastrograffin. No aspiration of contrast was noted in any patient. The opacification and delineation of the lesion on the X-ray films was much better with barium.
Conclusion. Barium is a better contrast medium in simulation for delineation of lesion length and treatment planning compared with gastrograffin. It is also cost effective. This comparison has changed the practice in our department, and it is recommended that it be evaluated by other centres.
Is selection for a registrar post in South Africa defined by a preconceived social profile or are candidates selected on academic credentials and work experience? : original articleSource: SA Journal of Radiology 11, pp 18 –23 (2007)More Less
A current trend towards specialisation exists amongst medical graduates worldwide. Available registrar positions are therefore limited and there is often strong competition for posts. South Africa has a unique political history, and as a result there are government directives promoting equal opportunities in order to correct the inequalities of the past. In other countries, race is considered to be an unimportant factor in residency selection, and registrars are chosen predominantly on merit. In this context, an anonymous survey was conducted amongst registrars in Radiology to determine whether selection for a registrar post in South Africa is defined by a preconceived social profile or whether candidates are selected on academic credentials and work experience. Our results showed that academic credentials and work experience are key criteria for the selection of registrars in South Africa. Gender equality is achieved in medical specialist training departments, but a marked racial misrepresentation exists despite current employment policies. The explanation for this finding warrants further study.
Author M. ModiSource: SA Journal of Radiology 11, pp 24 –26 (2007)More Less
The ectopic posterior pituitary (EPP) refers to the anomalous position of the distinctly bright posterior pituitary gland. Defective neural migration during embryogenesis is believed to be the cause of the EPP. This hypothesis is supported by the co-existence of other midline structural malformations where anterior pituitary hypoplasia and EPP are the end products.
The EPP often occurs in patients with growth hormone deficiency (GHD), and is a marker of GHD. The EPP should alert the radiologist to perform a precise MRI study as it is an important marker of anterior pituitary structure and function. The hyperintense posterior pituitary is due to its phospholipid content.
Pathological basal ganglia calcification in a patient with pseudohypoparathyroidism : pictorial interludeAuthor L. SweidanSource: SA Journal of Radiology 11 (2007)More Less