[Usefulness of magnetic resonance imaging in the diagnosis of early rheumatoid arthritis: a prospective study about 20 cases]

Diagnosing early rheumatoid arthritis is difficult and radiographic signs are often late. MRI detects erosions at an early stage and visualizes synovitis, bone edema and tenosynovitis. To assess the value of MRI for diagnosis of early forms of rheumatoid arthritis. Prospective study involving 20 patients who had non erosive rheumatoid arthritis lasting for less than 2 years. MRI of the hand was performed by sequences coronal and axial T1-weighted, T2 with saturated fat signal [FatSat] FatSat and T1 with gadolinium injection. The median age of patients was 52 years and sex ratio M/F of 0.05. The median disease duration was 9 months. Ten patients had antibodies Anti-Cyclic citrullinated protein positive. The MRI was abnormal in 75% of patients. This review found 36 erosions which 50% were in carpal bones, 55 joints with synovitis mainly localized midcarpal and metacarpophalangeal. Bone edema was found mainly in carpal bones. Tenosynovitis affected most frequently the flexor tendons. Seventy percent of patients without anti-Cyclic citrullinated protein had a pathological MRI. MRI has an important role in detecting infraradiological lesions in early RA. This contributes to early diagnosis and initiation effective treatment

[Extra - cardiac findings on coronary computed tomography scanning]

Multi-detector-row computed tomography [MDCT] has emerged as method for non-invasive imaging of the heart. To investigate the frequency of the non cardiac findings in cardiac imaging with MDCT. Atotal of 191 patients underwent cardiac imaging with 64-slice MDCT over a period of 8 months. The detected abnormalities were classified in major [implying an immediate workup and treatment or at least a further investigation] and minor abnormalities. Extra cardiac abnormalities were detected on 69 examinations [36%]. Major abnormalities were found in 17% of the patients, and the minor abnormalities in 25,6%. The scan revealed 4 cases of lung carcinomas, all at a still surgical stage. There were a significant number of non cardiac findings in cardiac MDCT. To avoid missing clinically important findings, we should carefully evaluate all the organs included in the scan

[Multi slice computerized tomography of the heart and coronary arteries]

Due to the recent technological progress, multislice computerized tomography [MSCT] allows visualizing the heart and coronary arteries. Multislice computed tomography is non invasive and provides high quality images.Its main limits are arythmia, tachycardia and coronary calcifications. But the main drawback with MSCT is the radiation dose. Report of usefuluess and indications of multislice CT scanner. Review of literature. Although the indications of MSCT did not reach a guideleness level yet, some trends can be stated. The advantages and limitations of MSCT in cardiac exploration are summarized in this article. The indications are mainly based on the excellent negative predictive value of MSCT regarding coronary artery disease. Hence, patients at low to moderate risk of coronary artery disease mostly benefit of the technique. MSCT can be an alternate examination in case of non feasible or non contributive ischemic test. MSCT is highly contributive in the ostial analysis, in detecting abnormal congenital coronary anomalies or in analysing bypass grafts. MSCT remains limited in patients with heavily calcified coronary arteries, and in patients with stented distal arteries. Multislice CT scanner should not be considered as equivalent to invasive coronary angiography bu it is a additional diagnostic tool

Post traumatic rupture in patients with uretero pelvic Junction obstruction: a Case Report

Authors report a case of post traumatic pelvic rupture occurring in an unknown ureteropelvic junction [UPJ] obstruction. Ultrasonography showed pyelectasia and fluid effusion in the anterior perirenal space. CT scan confirmed the diagnosis of UPJ obstruction and showed the rupture of the anterior pelvic wall communicating with a perirenal urinoma. The patient underwent a retrograde stenting for decompression and surgical drainage of the urinoma. Pyeloplasty was performed 4 months after injury. A follow up intravenous pyelogram showed good flow through the repair and the patient remaines asymptomatic 2 years after treatment Post traumatic rupture of UPJ obstruction is a rare event with few reported cases in literature Diagnosis is suggested on imaging studies. CT scan shows the rupture site in the ureteropelvic tract and guides percutaneous drainage