Is Magnetic Resonance Imaging Play a role in aiding the diagnostic value of COVID-19 Musculoskeletal induced pathologies?

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the seventh strain identified within the coronavirus family capable of infecting humans, is responsible for the onset of COVID-19 infection. Although musculoskeletal (MSK) manifestations frequently emerge as among the initial symptoms of COVID-19, their documentation remains comparatively limited, possibly resulting in their under recognition. Acute MSK symptoms, which manifest within a span of four weeks post-infection, typically encompass generalized fatigue and myalgia, exhibiting nonspecific characteristics. Objectives: This study’s goal is the use of MRI examination for evaluation of the different musculoskeletal pathologies in complaining COVID-19 patients. Patients and Methods: In this prospective study, which included 30 patients confirmed with COVID-19 through December 2023 to May 2024, MRI was tailored based on the area of interest depending on patient’s complaint. Results: Among the enrolled patients, myalgia was the most common presentation (36.7%), the most common MRI finding was synovitis and effusion (33.3%), and the least common was bone infarction (10%), with knee joint being the most commonly affected joint. Conclusion: Magnetic resonance (MR) imaging, either with or without contrast can help diagnosis and assessment of COVID-19 symptoms and consequences affecting the musculoskeletal system

Added value of Diffusion-Weighted Images & Contrast Enhanced Magnetic Resonance Imaging for the Diagnosis of Perianal Fistula

Background: The perianal surgical procedure is aimed at removing all infection sources related to the fistula and its tract, while preserving anal sphincter functions. Various peri-operative risk factors impact perianal fistula recurrence. Managing perianal fistula faces many challenges. MRI represents the preferred imaging technique for detecting the fistula's type as well as related adverse events Objectives: This work was aimed at differentiating between plain, DWI as well as contrast MRI studies, thus establishing the final protocol. Patients and methods: This prospective non-randomized study included a sample of 80 cases suspected to have perianal fistula, MRI was done for all of them including T2, contrast injection & DWI. The radio logical findings were correlated with surgical outcome. Results: This study included 80 patients developing perianal discharge or external perianal fistulous opening, contrast deemed to be beneficial within twenty-eight subjects since the enhancement of perifistulous inflammatory changes as well as the abscesses exhibited better delineation. Regarding to original tract; there was an agreement between Plain T2 and (DWI, contrast and surgery) while there was no agreement between DWI and (contrast and surgery) . Regarding to fibrosed tract, abscess and 2ry tract; there was an agreement between the four groups.. Regarding to internal opining; there was no agreement between Plain T2 and DWI and between DWI and (contrast and surgery) (P value =0.001). Conclusions: DWI represents a beneficial tool while assessing perianal fistula, yet contrast administration exhibits more sensitivity as well as specificity when identifying fistulas as well as their complications. It can be reliable especially in patient with any contraindication to contrast injection