SA Journal of Radiology - Volume 9, Issue 2, 2005
Volume 9, Issue 2, 2005
Author Mala ModiSource: SA Journal of Radiology 9, pp 3 –4 (2005)More Less
Extracted from text ... 3 SA JOURNAL OF RADIOLOGY . July 2005 EDITORIAL A new era at Wits Mala Modi MB BCh, FCRad (SA), MMed Department of Radiology Chris Hani Baragwanath Hospital University of the Witwatersrand Johannesburg When I was requested to do the editorial for this issue of SAJR from the Radiology Department of the University of the Witwatersrand, I was quite excited as it gave me the opportunity to be in 'Speakers Corner, Hyde Park'on a Sunday morning (cold and wet of course) and to express my views freely on the many issues that plague, as well as the occasional issues that ..
Management of HIV-associated focal brain lesions in developing countries - experience at Chris Hani Baragwanath Hospital : original articleSource: SA Journal of Radiology 9, pp 5 –13 (2005)More Less
<I>Background.</I> HIV-associated focal brain lesions (FBLs) are caused by opportunistic infections, neoplasms, or cerebrovascular diseases. In developed countries toxoplasma encephalitis (TE) is the most frequent cause followed by primary CNS lymphoma (PCNSL). Guidelines based on these causes have been proposed and successfully implemented. These guidelines do not consider the causes of HIV-associated FBL in developing countries where treatable infections predominate. The guidelines as proposed would adversely influence outcome if applied to patients in developing countries. <br><I>Objective.</I> To determine a practical approach to the management of HIVassociated FBLs in developing countries. <br><I>Design.</I> Prospective case series. <br><I>Methods.</I> Management based on presumed aetiologies of the FBLs determined by collating information obtained from computed tomography (CT) scans, cerebrospinal fluid and blood studies, concurrent nonneurological illness and response to treatment. <br><I>Results.</I> The principal presumed cause of FBL was tuberculosis (TB) (69%), and the therapeutic response was good in 69% of patients. <br><I>Conclusions.</I> In developing countries infections are the predominant cause of HIV-associated FBL. The principal cause is determined by the infection that is endemic to the population being studied. Empiric treatment based on limited investigations should be directed according to the nature of this infection.A modified algorithm is proposed.
CT scanning may adversely influence choice of surgery in paediatric papillary thyroid carcinoma - a note of caution : case reportAuthor S. AndronikouSource: SA Journal of Radiology 9, pp 14 –15 (2005)More Less
Papillary thyroid carcinoma may be multifocal in up to 50% of affected children. Surgeons must weigh the higher risks of recurrence when surgical resection is less than subtotal thyroidectomy against the higher risks of complications with subtotal / total thyroidectomy. An 11-year-old girl presented to our surgical department with a thyroid mass. Computed tomography (CT) revealed a lesion, missed by ultrasonography, which reversed the decision to perform conservative thyroid surgery. The lesion proved to be non-neoplastic. CT may be a useful adjunct when ultrasound demonstrates a solitary lesion and conservative surgery is considered, and may prove to be able to distinguish neoplastic from non-neoplastic lesions based on contrast enhancement characteristics, but caution is advised in assuming that all nodules are neoplastic.
Source: SA Journal of Radiology 9, pp 16 –18 (2005)More Less
Extracted from text ... Introduction Intracranial tuberculosis is an important cause of morbidity and mortality in developing countries where tuberculosis is endemic.1 In the central nervous system tuberculosis manifests as cerebritis, cerebral abscess, tuberculoma, and tuberculous meningitis (TBM).1-5 TBM is thought to arise from cerebrospinal fluid (CSF) seeding of a ruptured pial or subependymal granuloma.2-5 Tuberculomata result from haematogenous dissemination and histologically are granulomas with central areas of caseous necrosis.2-5 Tuberculomata may develop whilst patients are on treatment for TB.6 The co-occurrence of intracranial tuberculoma and TBM is well recognized. 2-5 Medical therapy is effective for both forms, with a high cure rate in ..
Bronchiolitis obliterans organizing pneumonia (BOOP) or cryptogenic organising pneumonia (COP) : case reportSource: SA Journal of Radiology 9, pp 19 –21 (2005)More Less
Extracted from text ... CASE REPORT 19 SA JOURNAL OF RADIOLOGY . July 2005 Introduction Bronchiolitis obliterans organising pneumonia (BOOP) is a distinct entity with various clinical, radiographic and prognostic features. Pathologically it is characterised by the presence of granulation tissue polyps within the lumina of bronchioles and alveolar ducts with patchy areas of organising pneumonia. Chronic inflammation is noted in the walls of the surrounding alveoli with preserved lung architecture. The preferred term is cryptogenic organising pneumonia (COP) when no aetiology is found.1-3 We report on a patient recently seen with this condition. Case report A 36-year-old woman presented with a history ..
Source: SA Journal of Radiology 9, pp 22 –24 (2005)More Less
Lemierre's syndrome (postanginal sepsis / necrobacillosis) is a rare clinical entity characterised by the triad of acute oropharyngeal infection, with secondary thrombophlebitis of the internal jugular vein and metastatic septic emboli. A high degree of clinical suspicion is needed to diagnose the syndrome and the radiologist's awareness of it may expedite the diagnosis and therefore the appropriate treatment for these potentially fatal sequelae of a 'sore throat'. <BR> We present a case of a 20-year-old man admitted to Helen Joseph Hospital in July 2004 with multiple lung abscesses, in whom internal jugular vein thrombophlebitis was subsequently diagnosed. Chest radiographic and computed tomography (CT) images accompany a brief review of this largely forgotten syndrome
Source: SA Journal of Radiology 9, pp 25 –27 (2005)More Less
Extracted from text ... Introduction Mesial temporal sclerosis is the commonest cause of partial complex seizures. The aetiology of this condition is controversial, but it is postulated that both acquired and developmental processes may be involved. Familial cases have also been reported. Magnetic resonance imaging (MRI) is the imaging investigation of choice for the diagnosis and has been shown to be highly sensitive and specific. Once diagnosed, medical treatment is successful in 25% of cases, whilst anterior temporal lobectomy is effective in 70 - 95% of patients.1 Case report The case under discussion involved a 42-year-old woman. She had had numerous previous admissions related ..