Traumatic diaphragmatic rupture, a diagnostic dilemma in the presence of eventration: a case report

Eventration of the diaphragm is the condition where the muscle is permanently elevated, but retains its continuity and attachments to the costal margins. Traumatic diaphragmatic rupture is a recognized consequence of high velocity blunt trauma to the abdomen usually a result of motor vehicle accident. Multi-slice CT and Magnetic Resonance Imaging in the pre-operative evaluation of trauma patients, diaphragmatic rupture can be still overlooked if not evaluated with the fair degree of clinical suspicion, more so if it is associated with an eventration of diaphragm - as was in our case

Prospective evaluation of lateral C punctures for cervical Myelography in diagnosing the compressive lesions.

It analyzed 100 cases in terms of age, sex, signs and symptoms. The most common symptoms were pain neck, occipital headache and weakness of limbs etc. Local, physical and systematic examinations were carried out and further specialized investigations were conducted. Before myelographic procedure patients were put on anticonvalsant therapy. Myelographic examination was done which revealed 24 negative cases and 76 positive cases. Disc prolaps was seen commonest myelographic diagnosis followed by traumatic compression. The study observed that C4-C5 were commonest level of compression and a good number of patients had compression at multi levels, After the procedure adverse effects were observed as headache, pain over injection site vomiting etc. 76 cases were treated surgically and 24 cases treated conservatively. The confirmation of myelographic findings were made by surgery. It concludes that cervical spine can be best reached and studied mylographically through a lateral C1-12 puncture. Lateral C1-2 puncture cervical mylography pricks up the lesion very accurately

Lupus mastitis - peculiar radiological and pathological features

Lupus mastitis is a form of lupus profundus that is seen in patients with systemic lupus erythematosus. It usually presents as a swelling (or swellings) in the breasts, with or without pain. The condition is recurrent and progresses along with the underlying disease, with fat necrosis, calcification, fibrosis, scarring, and breast atrophy. Lupus mastitis is often confused with malignancy and lymphoma and, in our part of the world, with tuberculosis. Confusion is especially likely when it occurs in an unusual clinical setting. In this article, we present a case that presented with unique radiological, pathological, and clinical features. Awareness of the various manifestations of lupus mastitis is essential if unnecessary interventions such as biopsies and surgeries, and their consequences, are to be avoided

Delirium in a 74-year-old man: correct imaging revealed the truth

Delirium is a cognitive disorder. DSM-IV criteria for delirium must include both acute onset and fluctuating symptoms; disturbance of consciousness (including inattention); at least one of the following: disorganised thinking, disorientation, memory impairment or perceptual disturbance; and evidence of a putative causal medical condition. Traditionally, the course has been described as transient in which recovery is likely to be complete if the underlying aetiological factor is promptly corrected or is self-limited. The most common precipitating causes in elderly include sepsis, dehydration and drugs. Work-up for delirium is limited to septic screening, baseline investigations and imaging. Patients with delirium without focal signs and with either evidence for a medical aetiology of delirium or pre-diagnosed dementia are at a very low risk of having focal lesions in their contrast-enhanced CT or MRI. We are presenting an interesting case of delirium with urosepsis whose imaging revealed milliary brain tuberculomas on contrast-enhanced MRI