Intravenous urogram as a first line investigation in comparison with ultrasound

The objective of was to evaluate the usefulness and efficacy of intravenous urogram in patients with urinary tract pathology detected on ultrasound and X-ray KUB. The duration of the study was from September 2007 to August 2009 and a total of 250 patients were included in this cross-sectional study by non probability purposive sampling technique. Ultrasound scans and intravenous urograms were conducted by/under direct supervision of consultant radiologist. Out of 254 patients, four were unable to complete the intravenous urogram due to reaction to the contrast medium; hence a total of 250 patients were included in the final study. There were 66 male and 184 female patients. Calculi [renal, ureteric and vesical] were seen in 139 patients, pefviureteric Junction obstruction in 9, double collecting system and/or ureter in 6, neurogenic bladder in 13, horseshoe/pancake kidney in 2, ectopic kidney in 1, ureterocele in 2, cystocele in 1 and bladder mass in 7 patients. In 14 patients, the tests conducted were inconclusive and further investigations were advised. 28 patients had no detectable urinary tract pathology on any of the diagnostic modality. Intravenous urogram should not be performed routinely as a first line investigation in every patient presenting with flank pain. However, in congenital anomalies, intravenous urograms are needed and should be performed after a preliminary ultrasound

Magnetic resonance imaging of lumbosacral spine to determine the cause of sciatica

To analyze the lumbosacral spine using MRI to determine the most common pathology responsible for sciatica. Descriptive cross sectional study. This study was conducted at the Department of Radiology, Military Hospital Rawalpindi from October 2005 to April 2006. One hundred patients presenting with unilateral or bilateral sciatica were studied. MRI lumbo-sacral spine was the modality used to determine the anatomical factors responsible for sciatica. These factors included disc prolapse, osteophytes formation, and thickening of ligamentum flavum. It was seen that prolapsed disc was the most common cause of sciatica [found in 71% of the patients]. Out of these cases, disc bulge was found in 50% of the patients, protrusion / herniation in 37%, and an extruded disc fragment in 7%. Osteophytes and hypertrophied facet joints were seen in 7% of the cases, while ligamenta flava were thickened in 22%. 38% of the patients were in the 4[th] decade of life. Disc bulge is the most common pathology of lumbosacral spine in patients presenting with sciatica