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  Citation statistics : Table of Contents
   2014| July-September  | Volume 24 | Issue 3  
    Online since July 18, 2014

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Morel-Lavallée lesion: A closed degloving injury that requires real attention
Anirudh V Nair, PK Nazar, Resmi Sekhar, PV Ramachandran, Srikanth Moorthy
July-September 2014, 24(3):288-290
DOI:10.4103/0971-3026.137053  PMID:25114393
Morel-Lavallée lesions are post-traumatic, closed degloving injuries occurring deep to subcutaneous plane due to disruption of capillaries resulting in an effusion containing hemolymph and necrotic fat. Magnetic resonance imaging (MRI) is the modality of choice in the evaluation of Morel-Lavallée lesion. Early diagnosis and management is essential as any delay in diagnosis or missed lesion will lead to the effusion becoming infected or leading to extensive skin necrosis.
  2 12,239 521
Transient angioedema of small bowel secondary to intravenous iodinated contrast medium
Kirankumar N Kulkarni, Rahul G Hegde, Ankit Balani, Anagha R Joshi
July-September 2014, 24(3):303-305
DOI:10.4103/0971-3026.137065  PMID:25114396
We report the clinical details and imaging findings of a case of transient angioedema of the small bowel following intravenous administration of non-ionic iodinated contrast material in a 17 year old female with no predisposing risk factors. Findings included long segment, symmetric, circumferential, low-density, bowel wall thickening involving the duodenum, jejunum, and most of the ileum on computed tomography scan obtained at 7 min following intravenous contrast material injection. This entity is self-limiting with a favourable clinical outcome and requires no specific treatment but only aggressive clinical monitoring.
  1 3,482 240
Bilateral congenital absence of flexor pollicis longus with thumb hypoplasia and thenar atrophy
Vikas Chaudhary, Harsha Sehgal, Shahina Bano, Pranjali R Parmar, Sanjay Kumar
July-September 2014, 24(3):268-270
DOI:10.4103/0971-3026.137044  PMID:25114390
Congenital absence of flexor pollicis longus with or without associated anomalies of thenar muscles and thumb is of rare occurrence. Inability to flex the interphalangeal joint of the thumb and absent dorsal wrinkles and flexion creases of the thumb are important clues to the diagnosis. Routine radiography and cross-sectional imaging help to confirm and document the condition. This article presents an extremely rare case of bilateral congenital absence of flexor pollicis longus tendon with thumb hypoplasia and thenar atrophy.
  1 6,196 528
Imaging in emphysematous epididymo-orchitis: A rare cause of acute scrotum
Anitha Mandava, R Prabhakar Rao, D Anjani Kumar, I Shiva Naga Prasad
July-September 2014, 24(3):306-309
DOI:10.4103/0971-3026.137067  PMID:25114397
Emphysematous epididymo-orchitis is an uncommon, acute inflammatory process of epididymis and testis characterized by the presence of air within the tissue. Patient presents with fever, acute pain, swelling and tenderness in the scrotum. Imaging is needed for rapid accurate diagnosis and to differentiate it from other causes of acute scrotum such as testicular torsion. We report a case of emphysematous epididymo-orchitis with imaging findings on plain radiography, ultrasound, CT and MRI and a brief review of the literature.
  - 4,962 276
Antral follicle count in normal (fertility-proven) and infertile Indian women
Arjit Agarwal, Ashish Verma, Shubhra Agarwal, Ram Chandra Shukla, Madhu Jain, Arvind Srivastava
July-September 2014, 24(3):297-302
DOI:10.4103/0971-3026.137061  PMID:25114395
Background: Antral follicle count (AFC) has been labeled as the most accurate biomarker to assess female fecundity. Unfortunately, no baseline Indian data exists, and we continue using surrogate values from the Western literature (inferred from studies on women, grossly different than Indian women in morphology and genetic makeup). Aims: (1) To establish the role of AFC as a function of ovarian reserve in fertility-proven and in subfertile Indian women. (2) To establish baseline cut-off AFC values for Indian women. Settings and Design: Prospective observational case-control study. Materials and Methods: Thirty patients undergoing workup for infertility were included and compared to equal number of controls (women with proven fertility). The basal ovarian volume and AFC were measured by endovaginal. USG the relevant clinical data and hormonal assays were charted for every patient. Statistical Analysis Used: SPSS platform was used to perform the Student's t-test and Mann-Whitney U-test for intergroup comparisons. Correlations were determined by Pearson's ranked correlation coefficient. Results: Regression analysis revealed the highest correlation of AFC and age in fertile and infertile patients with difference in mean AFC of both the groups. Comparison of the data recorded for cases and controls showed no significant difference in the mean ovarian volume. Conclusions: AFC has the closest association with chronological age in normal and infertile Indian women. The same is lower in infertile women than in matched controls. Baseline and cut-off values in Indian women are lower than that mentioned in the Western literature.
  - 24,515 844
Application Form

July-September 2014, 24(3):313-313
  - 1,543 111
Cases in Hepatobiliary and Pancreatic Imaging
George Koshy Chiramel
July-September 2014, 24(3):310-310
  - 1,935 210
Consent Form

July-September 2014, 24(3):314-314
  - 1,581 125
Pursuing a radiology career: Private practice or academic ?
Sanjay N Jain
July-September 2014, 24(3):207-208
DOI:10.4103/0971-3026.137021  PMID:25114381
  - 8,687 1,274
Guest Editorial
Malini Lawande
July-September 2014, 24(3):209-209
DOI:10.4103/0971-3026.137023  PMID:25114382
  - 2,179 141
Seronegative spondyloarthropathy-related sacroiliitis: CT, MRI features and differentials
Daya Prakash, Shailesh M Prabhu, Aparna Irodi
July-September 2014, 24(3):271-278
DOI:10.4103/0971-3026.137046  PMID:25114391
Seronegative spondyloarthropathy is a group of chronic inflammatory rheumatic diseases that predominantly affect the axial skeleton. Involvement of sacroiliac joint is considered a hallmark for diagnosis of seronegative spondyloarthropathy and is usually the first manifestation of this condition. It is essential for the radiologist to know the computed tomography (CT) and magnetic resonance imaging (MRI) features of spondyloarthropathy-related sacroiliitis as imaging plays an important role in diagnosis and evaluation of response to treatment. We present a pictorial essay of CT and MRI imaging findings in seronegative spondyloarthropathy-related sacroiliitis in various stages and highlight common differentials that need to be considered.
  - 50,888 3,108
Bone marrow lesions: A systematic diagnostic approach
Filippo Del Grande, Sahar J Farahani, John A Carrino, Avneesh Chhabra
July-September 2014, 24(3):279-287
DOI:10.4103/0971-3026.137049  PMID:25114392
Bone marrow lesions on magnetic resonance (MR) imaging are common and may be seen with various pathologies. The authors outline a systematic diagnostic approach with proposed categorization of various etiologies of bone marrow lesions. Utilization of typical imaging features on conventional MR imaging techniques and other problem-solving techniques, such as chemical shift imaging and diffusion-weighted imaging (DWI), to achieve accurate final diagnosis has been highlighted.
  - 19,741 2,305
MRI imaging of displaced meniscal tears: Report of a case highlighting new potential pitfalls of the MRI signs
Abhishek Prasad, Rahat Brar, Shaleen Rana
July-September 2014, 24(3):291-296
DOI:10.4103/0971-3026.137056  PMID:25114394
Magnetic resonance imaging (MRI) has been found to be an excellent imaging tool for meniscal injuries. Various MRI signs have been described to detect displaced meniscal injuries, specifically the bucket-handle tears. Although these signs are quite helpful in diagnosing meniscal tears, various pitfalls have also been reported for these signs. Double anterior cruciate ligament (ACL) sign refers to presence of a linear hypointense soft tissue anterior to the ACL, which represented the flipped bucket-handle tear of the meniscus. Disproportional posterior horn and flipped meniscus signs represent asymmetrically thickened horns of the menisci due to overlying displaced meniscal fragments. We report a case wherein MRI of the knee showed tear and displacement of the medial patellofemoral ligament (MPFL) and vastus medialis complex, medial collateral ligament (MCL), and posterior cruciate ligament (PCL) mimicking these signs. To our knowledge, internally displaced MPFL and MCLs have not been described as mimics for displaced meniscal fragments.
  - 9,627 845
Comparison of conventional MRI and MR arthrography in the evaluation of wrist ligament tears: A preliminary experience
Shivani Pahwa, Deep N Srivastava, Raju Sharma, Shivanand Gamanagatti, Prakash P Kotwal, Vijay Sharma
July-September 2014, 24(3):259-267
DOI:10.4103/0971-3026.137038  PMID:25114389
Aims: To compare conventional magnetic resonance imaging (MRI) and direct magnetic resonance (MR) arthrography in the evaluation of triangular fibrocartilage complex (TFCC) and intrinsic wrist ligament tears. Materials and Methods: T1-weighted, fat suppressed (FS) proton density plus T2-weighted (FS PD/T2), 3D multiple-echo data image combination (MEDIC) sequences and direct MR arthrography were performed in 53 patients with wrist pain. Images were evaluated for the presence and location of TFCC, scapholunate ligament (SLL) and lunatotriquetral ligament (LTL) tears, and imaging findings were compared with operative findings in 16 patients who underwent arthroscopy or open surgery (gold standard). Results: Sixteen patients underwent arthroscopy/open surgery: 12 TFCC tears were detected arthroscopically out of which 9 were detected on FS PD/T2 sequence, 10 on MEDIC sequence, and all 12 were detected on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in the detection of TFCC tears were 75%, 83.3%, and 100%, respectively. Out of the eight arthroscopically confirmed SLL tears, three tears were detected on FS PD/T2 sequence, five on MEDIC sequence, and all eight were visualized on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in detecting SLL tears were 37.5%, 62.5%, and 100%, respectively. One arthroscopically confirmed LTL tear was diagnosed on FS PD/T2 sequence, three on MEDIC sequence, and all five arthroscopically confirmed LTL tears were detected with MR arthrography. The sensitivities of PD, MEDIC sequences, and MR arthrography in detecting LTL tears were 20%, 40%, and 100%, respectively. Conclusions: MR arthrography is the most sensitive and specific imaging modality for the evaluation of wrist ligament tears.
  - 9,935 395
Role of MR spectroscopy in musculoskeletal imaging
Swati Deshmukh, Ty Subhawong, John A Carrino, Laura Fayad
July-September 2014, 24(3):210-216
DOI:10.4103/0971-3026.137024  PMID:25114383
Magnetic resonance spectroscopy (MRS) is an imaging approach that allows for the noninvasive molecular characterization of a region of interest. By detecting signals of water, lipids, and other metabolites, MRS can provide metabolic information for lesion characterization and assessment of treatment response. Although MRS has been routinely used in the brain, clinical applications within the musculoskeletal system have only more recently emerged. The aim of this article is to review the technical considerations for performing MRS in the musculoskeletal system, focusing on proton MRS, and to discuss its potential roles in musculoskeletal tumor imaging and the assessment of muscle physiology and disease.
  - 5,104 767
Peripheral nerve injury grading simplified on MR neurography: As referenced to Seddon and Sunderland classifications
Avneesh Chhabra, Shivani Ahlawat, Allan Belzberg, Gustav Andreseik
July-September 2014, 24(3):217-224
DOI:10.4103/0971-3026.137025  PMID:25114384
The Seddon and Sunderland classifications have been used by physicians for peripheral nerve injury grading and treatment. While Seddon classification is simpler to follow and more relevant to electrophysiologists, the Sunderland grading is more often used by surgeons to decide when and how to intervene. With increasing availability of high-resolution and high soft-tissue contrast imaging provided by MR neurography, the surgical treatment can be guided following the above-described grading systems. The article discusses peripheral nerve anatomy, pathophysiology of nerve injury, traditional grading systems for classifying the severity of nerve injury, and the role of MR neurography in this domain, with respective clinical and surgical correlations, as one follows the anatomic paths of various nerve injury grading systems.
  - 15,116 1,265
Bone tumor mimickers: A pictorial essay
Jennifer Ni Mhuircheartaigh, Yu-Ching Lin, Jim S Wu
July-September 2014, 24(3):225-236
DOI:10.4103/0971-3026.137026  PMID:25114385
Focal lesions in bone are very common and many of these lesions are not bone tumors. These bone tumor mimickers can include numerous normal anatomic variants and non-neoplastic processes. Many of these tumor mimickers can be left alone, while others can be due to a significant disease process. It is important for the radiologist and clinician to be aware of these bone tumor mimickers and understand the characteristic features which allow discrimination between them and true neoplasms in order to avoid unnecessary additional workup. Knowing which lesions to leave alone or which ones require workup can prevent misdiagnosis and reduce patient anxiety.
  - 112,907 5,242
Imaging of articular cartilage
Bhawan K Paunipagar, DD Rasalkar
July-September 2014, 24(3):237-248
DOI:10.4103/0971-3026.137028  PMID:25114386
We tried to review the role of magnetic resonance imaging (MRI) in understanding microscopic and morphologic structure of the articular cartilage. The optimal protocols and available spin-echo sequences in present day practice are reviewed in context of common pathologies of articular cartilage. The future trends of articular cartilage imaging have been discussed with their appropriateness. In diarthrodial joints of the body, articular cartilage is functionally very important. It is frequently exposed to trauma, degeneration, and repetitive wear and tear. MRI has played a vital role in evaluation of articular cartilage. With the availability of advanced repair surgeries for cartilage lesions, there has been an increased demand for improved cartilage imaging techniques. Recent advances in imaging strategies for native and postoperative articular cartilage open up an entirely new approach in management of cartilage-related pathologies.
  - 14,602 1,058
Imaging of cartilage repair procedures
Darshana Sanghvi, Mihir Munshi, Dinshaw Pardiwala
July-September 2014, 24(3):249-253
DOI:10.4103/0971-3026.137035  PMID:25114387
The rationale for cartilage repair is to prevent precocious osteoarthritis in untreated focal cartilage injuries in the young and middle-aged population. The gamut of surgical techniques, normal postoperative radiological appearances, and possible complications have been described. An objective method of recording the quality of repair tissue is with the magnetic resonance observation of cartilage repair tissue (MOCART) score. This scoring system evaluates nine parameters that include the extent of defect filling, border zone integration, signal intensity, quality of structure and surface, subchondral bone, subchondral lamina, and records presence or absence of synovitis and adhesions. The five common techniques of cartilage repair currently offered include bone marrow stimulation (microfracture or drilling), mosaicplasty, synthetic resorbable scaffold grafts, osteochondral allograft transplants, and autologous chondrocyte implantation (ACI). Complications of cartilage repair procedures that may be demonstrated on magnetic resonance imaging (MRI) include plug loosening, graft protuberance, graft depression, and collapse in mosaicplasty, graft hypertrophy in ACI, and immune response leading to graft rejection, which is more common with synthetic grafts and cadaveric allografts.
  - 4,931 368
Role of ultrasound in evaluation of peripheral nerves
Ashwin D Lawande, Sudhir S Warrier, Mukund S Joshi
July-September 2014, 24(3):254-258
DOI:10.4103/0971-3026.137037  PMID:25114388
Ultrasonography (USG) is an excellent cost-effective modality in imaging of peripheral nerves. With the newer high-frequency probes with different footprints which allow high-resolution imaging at relatively superficial location, USG can detect and evaluate traumatic, inflammatory, infective, neoplastic, and compressive pathologies of the peripheral nerves. This article describes the technique for evaluation of nerves by USG as well as the USG appearances of normal and diseased peripheral nerves.
  - 8,747 1,048
Radiology websites: Musculoskeletal imaging websites: Part 2
Inna K Indrajit
July-September 2014, 24(3):311-312
  - 3,136 257
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