Tuberculous cervical lymphadenitis (scrofula): USG, doppler and elastographic evaluation: report of two cases

Lymphadenitis is the most generic form of extra pulmonary manifestation of tuberculosis. It is both diagnostic and therapeutic challenge because it mimics various other pathologic processes and yields inconsistent physical laboratory findings. Diagnosis is quite difficult often requiring biopsy. It is also important to differentiate tuberculous from non-tuberculous mycobacterial cervical lymphadenitis as their treatment protocols are different. We are presenting a case report of two patients who presented with neck swelling. Elastography is a recent advance in the field of sonography helping in identifying nature of pathology. Sonography, doppler and elastographic findings are discussed

Computed tomographic evaluation of inflammatory sinonasal diseases

Background: Computed Tomography plays a major diagnostic role in patients with inflammatory sinonasal diseases and determines the mode of management by displaying the complex osteomeatal anatomy, determining anatomical variations, extent of disease and characterizing various inflammatory sinonasal diseases. Purpose of the study was to assess the role of CT in evaluation of inflammatory sinonasal diseases by evaluating the sensitivity and specificity of CT in diagnosis of various inflammatory Sinonasal diseases.Methods: In this hospital based prospective study 122 patients with symptomatic inflammatory sinonasal diseases were evaluated by 16 slice MDCT. CT diagnosis is correlated with final diagnosis obtained from findings of nasal endoscopy/Functional Endoscopic Sinus Surgery, histopathological examination and fungal culture. Statistical analysis was done by descriptive and inferential statistics using Test statistics (sensitivity, specificity, PPV, NPV and accuracy) and Z test for single proportions (Z value >1.96 is considered significant). Software used in the analysis was SPSS 17.0 version and graph pad prism 6.0 version and p <0.05 is considered as level of significance.Results: On correlating CT diagnosis with final diagnosis, Chronic Sinusitis had 98.41% sensitivity and 96.61% specificity, fungal sinusitis had 66.67% sensitivity and specificity 99.14%, polyps had sensitivity of 94.59% and specificity of 97.6%, the rest of the inflammatory conditions had sensitivity 93.7 % and 99% specificity. P value in all instances was <0.05, i.e. <0.0001, indicating the significance of the findings.Conclusions: CT is the diagnostic modality of choice in evaluation of various inflammatory pathologies and associated complications thereby planning the further management of the patient

Ultrasound and Doppler evaluation of salivary gland pathology

Background: Lesions of salivary gland are very commonly encountered in clinical practice. Only by Clinical examination alone it is difficult to differentiate between them and know its exact cause and etiology. It would definitely benefit the patient as well as the doctor if they could get an idea of the exact type of lesion affecting the salivary gland. Hence, this study was undertaken to demonstrate as how high resolution ultrasound imaging and use of colour Doppler can be useful in evaluation of salivary gland lesions.Methods: Duration of study was1yearwith sample size of 30 patients. This study has been conducted in the department of Radiodiagnosis JNMC, Sawangi, Wardha all cases irrespective of age and sex referred to the department were evaluated. Aloka Prosound Alpha 7 USG machine with a high resolution probe linear transducer was used. The lesions were evaluated by high resolution real time ultrasound and colour Doppler.Results: Most of the patients were in the age group 41-50years and had male preponderance. Most presented with unilateral swelling which was tender and firm in consistency. Amongst the study group saladenitis was most frequent finding followed by pleomorphic adenoma and carcinoma. Pleomorphic adenoma was most common neoplasm having predilection for the parotid gland. Saladenitis was most common in submandibular gland. The commonest histopathological finding was pleomorphic adenoma.Conclusions: The study concludes that High resolution ultrasound can differentiate various salivary gland lesions. Addition with colour Doppler ultrasound can increase its diagnostic accuracy. High resolution ultrasound with colour Doppler sonography should be first line of imaging modality in suspected cases of salivary gland lesions

Multiple endometrial polyps in a pre-menopausal woman-sonographic and elastographic findings with histopathological correlation

We are presenting a case report of a 34-year-old female with history of inter-menstrual bleeding PV and Menorrhagia since 6 months with multiple endometrial polyps. Ultrasound and elastography findings are discussed

Ultrasound and elastography imaging of carcinoma tongue with pathological correlation-a case report

Here we are presenting a case of 45 years old female with history of ulcerative lesion on right lateral border of the tongue for 6 months with metastatic lesion in the liver. USG and Elastographic imaging findings are discussed

Quantification of joint mobility limitation in adult type 1 diabetes

AimsDiabetic cheiroarthropathies limit hand mobility due to fibrosis and could be markers of a global profibrotic trajectory. Heterogeneity in definitions and lack of a method to measure it complicate studying associations with organ involvement and treatment outcomes. We measured metacarpophalangeal (MCP) joint extension as a metric and describe magnetic resonance (MR) imaging determinants of MCP restriction.MethodsAdults with type 1 diabetes were screened for hand manifestations using a symptom questionnaire, clinical examination, and function [Duruoz hand index (DHI) and grip strength]. Patients were segregated by mean MCP extension (&lt;20°, 20°–40°, 40°–60°, and &gt;60°) for MR imaging (MRI) scanning. Patients in the four groups were compared using ANOVA for clinical features and MRI tissue measurements (tenosynovial, skin, and fascia thickness). We performed multiple linear regression for determinants of MCP extension.ResultsOf the 237 patients (90 men), 79 (33.8%) with cheiroarthropathy had MCP extension limitation (39° versus 61°, p &lt; 0.01). Groups with limited MCP extension had higher DHI (1.9 vs. 0.2) but few (7%) had pain. Height, systolic blood pressure, and nephropathy were associated with mean MCP extension. Hand MRI (n = 61) showed flexor tenosynovitis in four patients and median neuritis in one patient. Groups with MCP mobility restriction had the thickest palmar skin; tendon thickness or median nerve area did not differ. Only mean palmar skin thickness was associated with MCP extension angle on multiple linear regression.ConclusionJoint mobility limitation was quantified by restricted mean MCP extension and had structural correlates on MRI. These can serve as quantitative measures for future associative and interventional studies

Breast fibroadenoma: diagnostic performance of gray-scale sonography and sonoelastography: a prospective observational study

Background: Elastography is a new technique that can be especially helpful when used as an adjunct to conventional B-mode ultrasound in evaluating breast lesions. The aim of this study was to evaluate the diagnostic performance of interpretation criteria for conventional sonography and sonoelastography in characterising fibroadenoma breast with pathological correlation.Methods: 50 breast fibroadenomas were prospectively evaluated by ultrasound as well as by strain elastography followed by FNAC//Histopathology correlation. The criteria used in breast elastography were Elastography Score and Strain Ratio. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated for each modality.Results: The elastography score was found to have the best performance among the 2 criteria used with a sensitivity, specificity and accuracy of 95.83%, 50% and 94% respectively.Conclusions: While conventional ultrasound remains the primary modality for the characterization of breast masses, elastography has the potential to improve the sensitivity, specificity and accuracy of conventional ultrasound and, thus avoiding unnecessary biopsy

Breast fibroadenoma: diagnostic performance of gray-scale sonography and sonoelastography: a prospective observational study

Background: Elastography is a new technique that can be especially helpful when used as an adjunct to conventional B-mode ultrasound in evaluating breast lesions. The aim of this study was to evaluate the diagnostic performance of interpretation criteria for conventional sonography and sonoelastography in characterising fibroadenoma breast with pathological correlation.Methods: 50 breast fibroadenomas were prospectively evaluated by ultrasound as well as by strain elastography followed by FNAC//Histopathology correlation. The criteria used in breast elastography were Elastography Score and Strain Ratio. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated for each modality.Results: The elastography score was found to have the best performance among the 2 criteria used with a sensitivity, specificity and accuracy of 95.83%, 50% and 94% respectively.Conclusions: While conventional ultrasound remains the primary modality for the characterization of breast masses, elastography has the potential to improve the sensitivity, specificity and accuracy of conventional ultrasound and, thus avoiding unnecessary biopsy

Ultrasound and Doppler evaluation of salivary gland pathology

Background: Lesions of salivary gland are very commonly encountered in clinical practice. Only by Clinical examination alone it is difficult to differentiate between them and know its exact cause and etiology. It would definitely benefit the patient as well as the doctor if they could get an idea of the exact type of lesion affecting the salivary gland. Hence, this study was undertaken to demonstrate as how high resolution ultrasound imaging and use of colour Doppler can be useful in evaluation of salivary gland lesions.Methods: Duration of study was1yearwith sample size of 30 patients. This study has been conducted in the department of Radiodiagnosis JNMC, Sawangi, Wardha all cases irrespective of age and sex referred to the department were evaluated. Aloka Prosound Alpha 7 USG machine with a high resolution probe linear transducer was used. The lesions were evaluated by high resolution real time ultrasound and colour Doppler.Results: Most of the patients were in the age group 41-50years and had male preponderance. Most presented with unilateral swelling which was tender and firm in consistency. Amongst the study group saladenitis was most frequent finding followed by pleomorphic adenoma and carcinoma. Pleomorphic adenoma was most common neoplasm having predilection for the parotid gland. Saladenitis was most common in submandibular gland. The commonest histopathological finding was pleomorphic adenoma.Conclusions: The study concludes that High resolution ultrasound can differentiate various salivary gland lesions. Addition with colour Doppler ultrasound can increase its diagnostic accuracy. High resolution ultrasound with colour Doppler sonography should be first line of imaging modality in suspected cases of salivary gland lesions