Computerised tomography findings of lymphobronchial tuberculosis in children: a comparison between infants and older children

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Medicine in Diagnostic Radiology. Johannesburg, 2015INTRODUCTION: Pulmonary tuberculosis (TB) in children is characterised by mediastinal and hilar lymphadenopathy. Lymphobronchial TB (LBTB) describes the situation where tuberculous lymph nodes affect the airways by compression or erosion. Infants may be more susceptible to severe complications due to their specific airway anatomy and immature immune systems. AIM: The purpose of this study was to compare the computerised tomography (CT) findings of infants and children older than 12 months with LBTB to determine whether infants are more severely affected in terms of bronchial compression secondary to mediastinal lymphadenopathy and the complications thereof. METHOD: The CT scans of 98 children (< 13 years) with LBTB were reviewed retrospectively by a paediatric radiologist for a previous study and the results captured in a database. The relevant data was extracted from the existing database and the two age groups were compared with regard to lymphadenopathy, airway narrowing and parenchymal complications. RESULTS: Of the 98 patients, 51% were infants. There was no statistically significant difference between infants and children older than 12 months with reference to the frequency and distribution of airway compressions, lymphadenopathy and parenchymal findings. However, there was a statistically significant difference (p<0.05) in the number of infants with complete compressions when compared to the older children. Infants also had a 1.9 times higher risk than older children, of having complete compressions. CONCLUSION: As opposed to older children, infants’ airways are more susceptible to complete airway compression as a result of LBTB. This is due to airway size and anatomic development. We therefore recommend that when infants present with symptoms of airway compression secondary to LBTB, they should be imaged using CT scanning and managed urgently.MT201

Chest radiograph interpretation for critical care nurses

Chest radiographs are one of the most common radiological investigations performed in a critical care setting and play a fundamental role in patient evaluation. Basic understanding of radiographic technique, anatomy and major pathologies is therefore essential for critical care nurses.https://journals.co.za/content/journal/mp_pnthttp://www.pntonline.co.za/index.php/PNTam2018Radiolog

The knowledge, awareness and practices of radiation safety amongst orthopaedic surgeons

BACKGROUND : Fluoroscopic imaging in orthopaedic theatres is increasing, with added risk to the orthopaedic surgeon who is increasingly being exposed to ionising radiation. It is thus crucial for orthopaedic surgeons to have a working knowledge of radiation safety. In spite of these concerns, however, many orthopaedic surgeons do not receive standard training in radiation safety. OBJECTIVES : The evaluation of orthopaedic surgeons’ knowledge, awareness and everyday practices regarding radiation safety in an academic hospital. METHODS : A questionnaire with multiple-choice-type questions was developed by a panel of experts and used to conduct a descriptive study. The questionnaire had multiple dimensions, each evaluating orthopaedic knowledge, awareness and practices, respectively. The study population included orthopaedic surgeons rotating within the orthopaedic circuit of the University of Pretoria. RESULTS : Orthopaedic surgeons regularly make use of fluoroscopic imaging in theatre, with 34 (77%) participants indicating that they use fluoroscopy in more than half of all their procedures performed. Most participants have insufficient knowledge of radiation safety, with the majority failing to correctly answer basic questions on radiation safety. Forty (91%) participants do not wear personal dosimeters, in spite of 39 participants (89%) believing that they are vulnerable to adverse effects. Basic radiation protection devices are underutilised, with 32 (73%) participants indicating that they have not received adequate training in radiation safety. CONCLUSION : The majority of orthopaedic surgeons regularly use fluoroscopic imaging in theatre yet lack in-depth knowledge and awareness regarding radiation safety associated with this imaging modality. Implementation of a radiation safety training programme is thus recommended.Dissertation was completed at the University of Pretoria:http://www.sajr.org.zaam2021Radiolog

Screening mammography - what your patients need to know

Worldwide breast cancer remains the most common cancer in women. In South Africa, one in 28 women will develop breast cancer during her lifetime. The risk is even greater for specific ethnic groups such as caucasian women where the risk increases to one in 12. Over the years the average age of women affected with breast cancer has decreased. Early detection and diagnosis of breast cancer is therefore essential. With the use of mammography, breast cancer can be detected before it is palpable. This aids in early detection of cancers that are still confined to the breast and require less aggressive management.https://journals.co.za/content/journal/mp_pntRadiolog

A general guide to patient preparation for radiological investigations

Imaging studies form an integral part of patient work-up and knowledge of patient preparation is essential to avoid unnecessary study cancellations and delays. Radiological imaging is comprised of several different modalities. The method of imaging dictates patient preparation. Some of the imaging modalities (radiographs, fluoroscopy and CT) use ionising radiation to obtain images whereas sonar and MRI are performed without the use of ionising radiation. Ultrasound essentially uses sound waves to evaluate the acoustic properties of tissues and MRI utilises magnets and radio waves. Some imaging modalities may also require the administration of intravenous contrast that further influences patient preparation. Patient preparation for imaging can be divided into two main categories: 1. Pre-existing conditions affecting the study or use of contrast agents 2. Study-specific preparationhttp://www.pntonline.co.za/index.php/PNTam2018Radiolog

The accuracy of magnetic resonance imaging diagnosis of non-osseous knee injury at Steve Biko Academic Hospital

BACKGROUND: Preoperative magnetic resonance imaging (MRI) has internationally been proven to reduce unnecessary knee arthroscopies and assist with surgical planning. This has the advantage of avoiding unnecessary surgery and the associated anaesthetic risk, as well as reducing costs. No data were found in the recently published literature assessing the accuracy of MRI interpretation of knee ligament injury in the public sector locally. OBJECTIVES: This pilot study aimed to determine the accuracy of MRI in detecting non-osseous knee injury in a resource-limited tertiary-level academic hospital in Pretoria, South Africa, compared to the gold standard arthroscopy findings. METHOD: This was an exploratory retrospective analysis of 39 patients who had MRI and arthroscopy at Steve Biko Academic Hospital (SBAH). True positive, true negative, false positive and false negative results were extrapolated from findings in both modalities and translated into sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for each structure. RESULTS: Negative predictive values were recorded as 97%, 81%, 90% and 100% (anterior cruciate ligament [ACL], medial meniscus [MM], lateral meniscus [LM] and posterior cruciate ligament [PCL], respectively), which were comparative to recently published international literature. The PPV results were lower than those previously evaluated at 55%, 58%, 55% and not applicable. The sensitivities and specificities of the ligaments were 83%, 58%, 83% and not applicable; and 87%, 81%, 70% and not applicable, respectively. CONCLUSION: Magnetic resonance imaging was found to be sensitive and specific, with a high NPV noted in all structures evaluated. Negative results can therefore be used to avoid unnecessary surgery to the benefit of the patient and state. The study reiterates that high accuracy can be obtained from MRI on a 1.5-tesla non-dedicated scanner, with interpretation by generalist radiologists.https://sajr.org.zapm2020Radiolog

Paediatric gastrointestinal volvulus: Twisting our heads around unusual diagnoses

No abstract available

Computerised tomography findings in lymphobronchial tuberculosis: A comparison between infants and older children

No abstract available