Evaluation of Bilateral Ureteral Urinary Jet Flows for Patency of Uretero- Vesical Junctions by Color Flow Imaging

Background: Ureters are meant to transport urine from the pelvis to the urinary bladder in the form of urinary jet. This is continuous process with intermittent release of urine at uretero-vesical junction. This is regulated by autonomous nervous system. The urine coming to urinary bladder can be seen by color flow imaging (CFI) .This also reflects the patency of the ureter without any obstruction in the pathway. Methods: The size of the population was 30 patients (20 males and 10 females). In this study, the Color Doppler ultrasound was used to evaluate the ureteral jets flow in 10 healthy patients and 20 patients with obstructive uropathy. A probability sampling method was employed while collecting samples. Results: In the right ureteral-vesical junction there was complete absence of detectable jets in 5 patients, 6 patients had weak flow of jet and 19 patients had normal flow of jet. Similarly, in the left ureteral-vesical junction there was complete absence of detectable jet in 3 patients, 12 patients had weak flow and 15 patients had normal flow. Conclusions: The color Doppler evaluation of the ureteral jets is a valid method of evaluating ureteral and renal calculi obstruction and could be a first line of investigation to detect ureteric obstruction in patients with obstructive uropathy.

Importance of Hoffa’s Pad Sign in MRI evaluation of various knee pathologies: a study conducted at SGT Hospital of SGT University of Gurugram Haryana

Hoffa’s fat pad is intracapsular and extra synovial structure present behind the patella and Infrapatellar tendon. This is delineated nicely in magnetic resonance imaging(MRI) by which it has become a modality of choice for its evaluation .The evaluation is by disruption of the outline of this region due to injury or other underlying pathologies .The indirect signs of this fat pad corresponds to the grading of associated trauma or underlying disease. Methods: We had conducted the MRI knee studies of fifty three patients which included both the genders from March 2018 to July 2018 .They all were having complaints of knee pain because of different aetiologies This cross sectional study included from 7-70 years of age group and patients were evaluated for the characteristics of Hoffa’s pad in MRI .The morphological characters of the region were studied and correlated in relation to the corresponding pathology. Results: There was excellent delineation and intensity relationship of HFP in various MRI sequences. The most vulnerable group to the changes was in 21- 30 years age group .The trivial trauma was the most common cause. The left knee was affected more than the right. Conclusion: Hoffa’s fat pad sign is an excellent indicator in various knee pathologies during MR evaluation. This also helps to know the involvement of the associated surrounding structures .MRI evaluation is very helpful in the decision making for the line of management.

Evaluation of Ossification of Iliac Crest in Children as Per Risser’s Sign in Gurugram Region of Haryana

Background: Risser’s sign is a good indicator of skeletal maturity in pediatric age group. The observations drawn from this can be well documented for the age verification and in relation to some pathologies. Ossification centers are evaluated with their further fusion. Methods: We carried out the evaluation by this sign in judging the exact skeletal maturity. Twenty one individual group comprising of eight females and thirteen males were included in this study. All children underwent pelvic radiography with antero-posterior view. Their iliac crest ossification and fusion was evaluated. Results: Grading of ossification of ileal cartilage was done as per the percentage extent of the ossification from Grade I to V. Conclusion: It was observed that there is delay of skeletal maturity in females as compared to males of the same age group in Gurugram region of Haryana which is contrary to the earlier studies conducted in general.

Adenoma Malignum of Cervix – How Useful is Clinico- Radiological Diagnosis.

Adenoma malignum (AM) is a rare type of variant of cervical cancer. The entity remains silent because of common complaints of erratic menstrual cycles and leucorrhea in peri-menopausal age group of females. The imaging modalities play a great role in clinching the diagnosis before the final confirmation by histopathological examination. We present 60- years old post menopausal woman who reported to gynecology outpatient department with complaints of per vaginum bleeding and watery discharge of six months duration .She was evaluated by cross imaging modalities of ultrasound (US) ,color flow imaging(CFI) and magnetic resonance imaging (MRI) with working diagnosis of adenoma malignum of cervix..This was subsequently confirmed in histopathological examination. The importance of the case lies because of the early diagnosis by clinic-radiological evaluation in the light of poor prognosis and early dissemination of this entity.

Normal Functioning Pelvic Lump Kidney: Isolated Anomaly - Radiological Evaluation.

There is wide spectrum of Mullerian dysgenesis presenting in different ways. Routine ultrasound done of a child for pain abdomen discovered a pelvic mass supero-posterior to the urinary bladder. This was diagnosed as fused pelvic kidneys by various cross sectional imaging modalities like Computerized tomography (CT) and Magnetic resonance imaging (MRI).We present a 4-years male child who was diagnosed as a case of “lump kidneys” by plain sonography coupled with color flow imaging (CFI). The entity usually falls in the common group of VATER (vertebral, anorectal malformation, esophageal and renal) anomalies. But our present case was having isolated anomaly and this entity is of a great rarity as seen in literature.

Bilateral primary Non-Obstructive and Non-Refluxing Megaureter in Child: Diagnosis by Non-Radiation Imaging Modalities.

Bilateral megaureters can present as asymptomatic or symptomatic pathology in the form of flank pain or urinary tract infection. The entity can also be diagnosed in antenatal ultrasound scan. We present 12-year old male child who presented with both flank vague pain and was subjected to ultrasonography (US) and Magnetic Resonance Urography (MRU). There was no evidence of any reflux or obstruction noticed as uretero-vasical junctions were normal on both sides. He was diagnosed as a case of bilateral primary non obstructive megaureters. Base line study was carried out by non radiation modalities in our institute for further follow up.

Atypical iliac unicameral bone cyst – An incidental finding in MRI.

is no expansion of the bone with unicameral bone cysts but in our present case there was expansion making it atypical presentation. We present a 22-year male who underwent MRI for Lumbosacral spine for his vague low backache symptoms. There was incidental finding of bony lesion in left iliac bone which turned out to be simple bone cyst. The study of Lumbosacral spine was unremarkable.

Mature Ethmoid Sinus Osteoma - Incidental finding in CT.

Paranasal osteomas are not uncommon to be found as an incidental finding in routine radiological examinations. Many a times, this entity is found while undergoing computerized tomography (CT) for some other reason. Sometimes, patient comes with vague complaints not related to this finding but indirectly is responsible for few of these symptoms. We present a case of 18-years old male who presented with the complaint of vague headache of about one year duration. He underwent CT examination and was found to be having slightly uncommon mature type of ethmoid osteomas in addition to pan sinusitis.