ABSTRACT
Background: Diagnosis of abdominal trauma is a real. Diagnostic tools that help the treating doctor in optimum management of abdominal trauma include; Focused Assessment with Sonography for Trauma (FAST), Diagnostic peritoneal lavage (DPL) and CT Scan. Objectives: The aim of this communication was to define the recent role of FAST and CT scan of the abdomen in the diagnosis of abdominal trauma. Material and methods: This study aimed at evaluating patients who came to the Radiology Department of Dhiraj General Hospital, by using USG and CT scan. This study comprised of 50 patients. Results: Out of 50 patients of abdominal trauma, 12 patients (24%) were in age group 21-30 years with male to female ratio of approximately 5.2: 1. The commonest mode of trauma was road trafic accident according for 54% of total cases. Spleen and liver were the most common organs injured, followed by kidney. USG showed overall sensitivity 57.48%, specificity 97.77%, positive predictive value 88.9125, negative predictive value 97.185 and accuracy of 90.75%. CT scan showed highest sensitivity of 95.35%, specificity of 100%, positive predictive value of 100%, negative predictive value 77.78% and accuracy 96%. Conclusion: FAST is useful as the initial diagnostic tool for abdominal trauma to detect intra abdominal fluid. With proper training and understanding the limitations of ultrasound, the results of FAST can be optimized. DPL is indicated to diagnose suspected internal abdominal injury when ultrasound machine is not available, there is no trained person to perform FAST, or the results of FAST are equivocal or difficult to interpret in a hemodynamically unstable patient. In contrast, in hemodynamically stable patients the diagnostic modality of choice is CT with intravenous contrast. It is useful to detect free air and intra peritoneal fluid, delineate the extent of solid organ injury, detect retroperitoneal injuries, and help in the decision for conservative treatment. Helical CT is done rapidly which reduces the time the patient stays in the CT scan room. Furthermore, this improves sagittal and coronal reconstruction images which are useful for detecting ruptured diaphragm.
ABSTRACT
Background: To recognize different pathologies affecting the shoulder joint with the help ultrasound and MRI scans and to evaluate the features, pattern and extension of the different pathologies affecting the shoulder joint with help of ultrasound and MRI scans so as to help the clinician for further management. Aim: To estimate role of ultrasound and MRI in examination of shoulder joint. Material and methods: Study comprised of an observational hospital based study. Out of 65patients, 20 underwent only ultrasound investigation, 25 underwent only MRI scans whereas 20 patients were evaluated by ultrasound and MRI. These were performed by 3-5 MHZ curvilinear probe and 8-10 MHZ linear probe on HD 7 and HD 9 Philips ultrasound machines and 1.5 T Philips MRI machine. MR arthrography was performed as a follow up in some of the patients in outside centre. Results: USG study also showed that the most commonly occurring rotator cuff tears were supraspinatus tears whereas alone infrspinatus and subscapularis tears were very rare. MRI study showed supraspinatus tears Were the most frequently occurring in the rotator cuff whereas subscapularis and infraspinatus tears were the most commonly occurring rotator cuff tears were supraspinatus tears whereas alone infraspinatus and subscapularis tears were very rare. MRI study showed supraspinatus tears were the most frequently occurring in the rotator cuff whereas subscapularies and infraspinatus tears were rare. MRI is 100% confirmative in almost all cases of Rotator cuff tears but may sometimes need extra imaging by MR arthrography in partial bursal tears. Conclusion: Rotator cuff tears are the most common pathologies affecting the shoulder joint according to this study. It was proved that, there is no evident difference in the accuracy of ultrasound and MRI in detecting this pathology, even though MRI has proved to be more accurate in evaluating almost all other pathologies as compared to ultrasound.