Glomus tumor-a diagnostic dilemma

To see the diagnostic utility of Xrays, MRI and C.T. scan in the diagnosis of glomus tumor. Descriptive study done from 1998 to 2005 at the department of plastic and reconstructive surgery Hayatabad Medical Complex, Peshawar. All cases diagnosed clinically as glomus tumor of the frigers were included in the study. The major presenting features were pain in12 patients and bluish discoloration of nail in 4 patients. On examination local tenderness was present in 9 patients and ice cube test was positive in 7 patients. Confirmation was done by histology in all cases. All patients were subjected to radiological examination while specialized tests like MRI was performed in 10 patients and CT scan in 2 patients. Twelve patients were included in the study. Positive findings on MRI and X-rays were observed in only, three patients and in one patient on CT scan. X-Ray findings were negative in 9 out of 12 patients [75%] while MRI finding were negative in 7 out of 10 patients [70%] and CT scan was done in 2 and was negative in 1patient [50%]. Keeping the high cost of MRI and poor results in small size tumors it is recommended to depend on clinical findings and histology to establish the diagnosis rather than CT and MRI

Maxillofacial trauma: Current practice in management at Pakistan institute of medical sciences

This study was carried out to determine the aetiology, pattern and management of maxillofacial injuries at PIMS, Islamabad. This descriptive study was conducted at Plastic Surgery Department, PIMS Islamabad from 1st February 1998 to 30th April 2002. All the adult patients presenting with maxillofacial injures were included where as patients less than 12 years of age and only facial lacerations were excluded. Similarly isolated nasal bone fractures were also excluded because these patients were routinely managed by ENT department. Age, sex, presentation, aetiology, associated injuries and treatment modalities undertaken in these patients were recorded. In 164 patients 254 fractures were noted. Most were male [86%], ranging in age from 13'71 years with a male to female ratio of 6:1 respectively. The most frequent [48%] cause noticed was road traffic accidents followed by assault. Mandible was the commonest to be involved in such injuries followed by maxilla. Most of the patients [32%] had associated facial injuries. Various treatment modalities were practiced. Maxillofacial fractures should be managed by open reduction and internal fixation as early as possible