Assessment of menisci and ligamentous injuries of the knee on magnetic resonance imaging: correlation with arthroscopy

OBJECTIVE: To evaluate the validity of MRI, in the assessment of the meniscal and cruciate ligamenteous injuries of the knee joint and comparison with arthroscopic findings. METHODS: A one year prospective cross-sectional study from January 2006 to January 2007, was performed on 50 patients (32 males & 18 females) with knee injury presenting at the orthopedic unit of AKUH. The patients were referred to radiology department for MRI evaluation and arthroscopy. RESULTS: The sensitivity, specificity and accuracy for MRI of the menisci and ligaments were as follows: medial meniscus resulted in 100% sensitivity, 69.27% specificity, 90% PPV, 100% NPV and 92% accuracy: lateral meniscus resulted in 87.5% sensitivity, 88.23% specificity, 77% PPV, 93% NPV and 88% accuracy: anterior cruciate ligament resulted in 86.67% sensitivity, 91.43% specificity, 81% PPV, 94% NPV and 88% accuracy; posterior cruciate ligament resulted in 100% sensitivity, 95.83% specificity,50% PPV, 100 NPV and 96% accuracy. CONCLUSION: Magnetic resonance imaging is a good, accurate and non invasive modality for the assessment of menisci and ligamenteous injuries. It can be used as a first line investigation in patients with soft tissue trauma to knee

Clinical radiology research in Pakistan: from evidence to practice

OBJECTIVE: To assess the clinical radiology research productivity in Pakistan by type of publication, sources of funding and name of journals. METHODS: A systematic search strategy using key words related to techniques and type of clinical radiology was carried out to identify various studies published in Indexed (Medline) and non-indexed (Pakmedinet) medical journals. RESULTS: Total of 397 studies were identified out of which 173(43%) from Medline (indexed database) and 220 (57%) from pakmedinet (Indexed and non- indexed database of Pakistan Medical journals). Original articles were 294 (74%) but most of them (68%) were published in non-indexed journals and significantly different from other articles types (case reports, short reports, review articles and letter to editors) (p-value \u3c 0.001). No Randomized Controlled Trial was identified. No research was funded by any formal financial agency. As high as 78% of indexed studies were published by radiology centers of Sind province. Private hospitals having radiology department contributed significantly in indexed journals compared to government hospitals (p-value \u3c 0.001). Majority (74%) of the studies were done by radiologists as compared to other non-radiology clinical colleagues (p-value \u3c 0.001). The most preferred journal for publication was the Journal of Pakistan Medical Association (JPMA; N = 43) followed by Annals of King Edward medical college (Ann KEMC; N = 20). Australasian journal of radiology was the most preferred international journal for publication (Australas Radiol N = 3). No significant difference was found in radiology research production in terms of number of publication from and before the year 2000 (p-value 0.51). CONCLUSION: Clinical radiology research production from Pakistan is low in terms of quality and number. Only few studies reach the standard of publication in international medical journals. There is an urgent need of building the foundation of research programmes in radiology and strengthen research capacity building at facility and health policy level

Staging of endometrial carcinoma by magnetic resonance imaging: correlation with surgery and histopathology

OBJECTIVE: To evaluate the accuracy of MRI in staging of endometrial carcinoma, and comparison with surgery and histopathological findings. METHODS: A one year prospective cross-sectional study was conducted from 10/3/2005 to 31/5/2006, at the Radiology department, Aga Khan University Hospital (AKUH) Karachi. Fifty two patients with diagnosis of endometrial carcinoma, referred to radiology department for preoperative staging by MRI and had undergone surgery were included. RESULTS: MRI was found to be 79% sensitive, 85% specific and 80% accurate for staging endometrial carcinoma while PPV and NPV were 97% and 66% respectively. CONCLUSION: Magnetic resonance imaging is a good, safe, accurate and non invasive imaging modality in staging of endometrial carcinoma. It can be used as a first line radiological investigation in patients with endometrial carcinoma for treatment planning