Plica syndrome - a neglected diagnosis in knee pain

The Plica syndrome is a neglected diagnosis in knee pain. The purpose of this article is to emphasize the diagnosis of Plica syndrome by MRI knee, which affects the patient management. Retrospective evaluation of MRI knee revealed the diagnosis of Plica syndrome in otherwise reported normal MRI knee. The synovial plica are easily appreciated as low signal bands on sagittal and axial T1 and T2 weighted images at the anatomic locations of knee joint. Out of 737 reported normal MRI knee, five cases revealed thick bands of plica, which in clinical setting of knee pain and trauma, suggested the diagnosis of Synovial Plica syndrome at MRI and confirmed by arthroscopy. MRI knee is an easy, non-invasive method to diagnose the synovial plica syndrome, which can affect the patient management and avoiding unnecessary arthroscopy

Sonographic diagnosis of infantile hypertrophic pyloric stenosis- use of simultaneous grey-scale and colour doppler examination

To evaluate the accuracy of Ultrasound in the diagnosis of Infantile Hypertrophic Pyloric stenosis, especially with simultaneous use of grey-scale and colour Doppler examination of pylorus. Fifty two infants with suspected Infantile Hypertrophic Pyloric stenosis [IHPS] were evaluated with grey-scale and colour Doppler examination. The sonographic findings were categorized as positive IHPS, negative IHPS and equivocal cases. Positive sonographic findings in 21 infants [40%] were confirmed at surgery. Negative sonographic findings in 27 infants [52%] were followed by ward chart reviews. Sensitivity, Sepcificity and Accuracy of grey-scale and colour Doppler examination for the diagnosis of IHPS were 1005. Sonography is the method of choice for the diagnosis of IHPS. Simultaneous grey-scale and colour Doppler examination of pylorus for suspected IHPS is more accurate than simple grey-scale sonography

Therapeutic efficacy of Hysterosalpingography with special reference to application of hydrostatic pressure during the procedure

Background: In the majority of infertile females, cause lies within the fallopian tubes. The causes for tubal obstruction include tuabal endometriosis, chlamydial and tuberculous infections, salpingitis, due to previous tubal approach, previous tubal pregnancy, peritubal adhesions due to previous appendicectomy, ovarian, uterine or adnexal operations. Other less important but easily treatable significant causes include tubal obstruction due to debris, fine adhesions or even unexplained tubal spasm. The later group can be managed with selective fallopian tube catheterization. Proximal tubal obstruction is seen in 10-20% of HSG examinations.The purpose of this study was to treat the infertility due to proximal fallopian tube obstruction with application of hydrostatic pressure during hysterosalpingography [HSG] technique

Methods: A study of consecutive hundred women of 18-30 years [mean age=24 years] who were clinically suspected of proximal fallopian tube obstruction [FTO] or unexplained infertility were included in this study. Women with other organic causes were excluded from the study. All the selected women underwent for HSG examination within 10 days of the menstrual cycle [3-4 days after the bath] by applying 10 days rule and with the application of hydrostatic pressure using water soluble contrast medium during the procedure. Women with successful opening of fallopian tubes [47%] after the application of hydrostatic pressure were followed for 3-6 months for the pregnancy

Results: The fallopian tubes were patent in 57 [57%] women and appeared obstructed in 43 [43%] females [33 unilateral and 10 bilateral]. With application of hydrostatic pressure during HSG technique, 25 [47%] fallopian tubes in 22 women reveal prompt opening while 28 tubes in 21 women remain blocked. The rate of successful conception was observed in 6 [24%] women within 3-6 months after the procedure

Conclusion: Application of hydrostatic pressure during the HSG examination offers a promising technique for the management of minimal proximal fallopian tube obstructions due to debris, fine adhesions and even in unexplained tubal spasm. Therefore, being minimally invasive and cost-effective, this technique may be adopted in all the suspected proximal fallopian tube obstruction or unexplained infertility, especially prior to selective fallopian tube catheterization [FTC], laparoscopy and laparotomy

Therapeutic efficacy of hysterosalpingography with special reference to application of hydrostatic pressure during the procedure

In the majority of infertile females, cause lies within the fallopian tubes. The causes for tubal obstruction include tuabal endometriosis, chlamydial and tuberculous infections, salpingitis, due to previous tubal approach, previous tubal pregnancy, peritubal adhesions due to previous appendicectomy, ovarian, uterine or adnexal operations. Other less important but easily treatable significant causes include tubal obstruction due to debris, fine adhesions or even unexplained tubal spasm. The later group can be managed with selective fallopian tube catheterization. Proximal tubal obstruction is seen in 10-20% of HSG examinations.The purpose of this study was to treat the infertility due to proximal fallopian tube obstruction with application of hydrostatic pressure during hysterosalpingography [HSG] technique. A study of consecutive hundred women of 18-30 years [mean age=24 years] who were clinically suspected of proximal fallopian tube obstruction [FTO] or unexplained infertility were included in this study. Women with other organic causes were excluded from the study. All the selected women underwent for HSG examination within 10 days of the menstrual cycle [3-4 days after the bath] by applying 10 days rule and with the application of hydrostatic pressure using water soluble contrast medium during the procedure. Women with successful opening of fallopian tubes [47%] after the application of hydrostatic pressure were followed for 3-6 months for the pregnancy. The fallopian tubes were patent in 57 [57%] women and appeared obstructed in 43 [43%] females [33 unilateral and 10 bilateral]. With application of hydrostatic pressure during HSG technique, 25 [47%] fallopian tubes in 22 women reveal prompt opening while 28 tubes in 21 women remain blocked. The rate of successful conception was observed in 6 [24%] women within 3-6 months after the procedure. Application of hydrostatic pressure during the HSG examination offers a promising technique for the management of minimal proximal fallopian tube obstructions due to debris, fine adhesions and even in unexplained tubal spasm. Therefore, being minimally invasive and cost-effective, this technique may be adopted in all the suspected proximal fallopian tube obstruction or unexplained infertility, especially prior to selective fallopian tube catheterization [FTC], laparoscopy and laparotomy