Clinical Profile and Outcome of Conservatively Managed Emphysematous Pyelonephritis

Emphysematous pyelonephritis (EPN) is a severe, necrotizing renal parenchymal infection characterized by production of intraparenchymal gas. EPN predominantly affects female diabetics and immunocompromised patients. In a three-year period 2008–2011, a total of 8 patients were admitted to our hospital. All of them were diabetics, and both males and females were equally affected. These patients showed vague symptoms at admission and frequently presented with fever, loin pain, dysuria, and pyuria necessitating urgent medical attention. EPN required radiological diagnosis. CT scan revealed bilateral EPN with urinary obstruction and hydronephrosis in 50% of patients. Escherichia coli was found to be the causative organism in all the patients. Treatment comprised of resuscitation, normalization of serum electrolytes and blood sugars, administration of parenteral antibiotics, and relieving ureteric obstruction if present. All the patients improved with conservative management without any mortality

Assessment of radiological changes involving the articular surface of the temporomandibular joint in patients with osteoarthritis and rheumatoid arthritis using computed tomography scan: A prospective clinico-radiological study

Background and Objective: The purpose of the present study was to assess the radiological changes involving the articular surfaces of temporomandibular joints (TMJs) in patients with osteoarthritis (OA) and rheumatoid arthritis (RA) using computed tomography (CT) scans. Materials and Methods: A total of 20 patients with OA and 20 patients with RA were subjected to a detailed examination, routine radiography, and CT imaging of the TMJs. CT scanning was carried out for the direct axial view and reconstructed to coronal and sagittal planes with contiguous slice thickness of 2 mm using bone window. All the images were evaluated for the presence of osteophytes, flattening of the articular surfaces, sclerosis, and narrowing of the joint space and subjected to statistical analysis. Results: The female to male ratio of the study group for OA and RA was 2:1, respectively. Of all the CT findings, namely, osteophytes, flattening of the articular surfaces, sclerosis, and narrowing of the joint space, statistically significant values (P = 0.056) for osteophytes were obtained. Flattening and narrowing of joint space were seen in both types of arthritides, however, a relatively higher percentage of such patients was seen in RA group. Conclusion: OA and RA of the TMJ are the two most commonly seen conditions which can impair the functional capacity of the entire masticatory system. Their in-depth clinical and radiological evaluation is a must to assess the disease activity. Likewise, CT is a valuable tool in assessing osseous abnormalities and should be used in cases where osseous involvement of the TMJs is suspected