Endoscopy versus radiology in African AIDS patients with oesophageal disorders

Upper gastrointestinal endoscopy and double contrast barium radiology were compared prospectively in 45 Ugandan patients with AIDS and upper gastrointestinal oesophageal symptoms. Both investigating techniques were normal as was the histopathology in 5 patients. In 40 cases a definite pathological diagnosis (candidiasis; non-specific inflammation; malignancy) was made. Endoscopic examination provided a correct disgnosis in 38 cases; while only 15 cases were diagnosised from barium studies. Radiology was normal in 2 cases later proved to have definite pathology on endoscopy and histopathologic examination (oesophageal candidiasis). Endoscopy in this series was found to have 95sensitivity in diagnosing oesophageal disorders in AIDS patients; compared to a sensitivty of 37.5for radiology. The difference between the two procedures regarding sensitivity was statistically significant (p0.005). A combination of oral thrush and dysphagia was strongly associated with oesophageal candidiasis (positive predictive value 95; p0.0025). Endoscopy would be the ideal diagnostic procedure for oesophageal candidiasis. The above finding; however; provide a basis for empirical antifungal theraphy especially in places where diagnostic facilities are limited

Osteogenesis imperfecta: a report of 3 cases in Uganda Africans

3 cases of osteogenesis imperfecta (0.1) seen at Mulago Hospital diagnosed as per clinical and X-ray appearances are presented. Case No. 1 is that of a neonate who died 6 hours and 20 min. after delivery. Postmortem X-rays were done confirming the clinical suspicion of 0.1 Case No. 2 an infant of 8 months was X-rayed because of weakness of lower limbs since 3 months of age. The films led to the diagnosis. The 3rd case with typical radiological features was retrieved from the departmental archieves and no history was available. The salient radiological features; namely cortical thinning; scanty spongiosa and multiple fractures; healing with scanty callus were common to all the three cases above. 0.1 is not an uncommon bone dysplasia in Uganda Africans

The value of sonography in breast disease management at Mulago hospital

Seventy one consecutive patients presenting with breast symptoms to Mulago Hospital Radiology Department for the years 1990 and 1991 underwent breast sonography. They in addition all had conventional mammography performed. The results of sonography were analysed taking into consideration the clinical picture and mammographic findings. Breast biopsies were done where necessary. Abnormal sonographies were seen almost exclusively in patients with palpable lumps. The lesions were largely hypoechoic. Chronic inflammatory masses and carcinoma had similar appearance. Fibroadenosis a common entity showed no sonographic abnormality. Cystic lesions were well demonstrated with Ultrasound. Ultrasound is useful as a complimentary breast imaging technique to mammography. It is ideal in demonstrating cystic lesions but shows no specific pictures for carcinoma. It cannot be used for routine screening