Screening of Painful Hip Joint with Radiography and MRI

The basic tool for hip joint study is radiography. Pelvic radiograph helps in deciding whether the hip joint is normal and also includes opposite hip joint for comparison. It also helps in identification of signs of degenerative and inflammatory changes, avascular necrosis, soft tissue calcification and bone tumours. The investigation of choice to assess the bone marrow, acetabular labrum, articular cartilage, peri-articular muscles, tendons, ligaments and bursae is MRI. Pain at hip joint has different aetiologies divided into intra-articular, peri-articular and extra-articular conditions in adults and children. This study is being done to evaluate painful hip joint with radiography and MRI.METHODS50 cases of painful hip joint referred to the Radiology Department, Bharati Hospital were evaluated with radiography and MRI over a period of 24 months.RESULTSOut of 50 patients 20 were diagnosed as AVN, 10 cases showed changes of osteoarthritis, 7 cases had joint effusion, 5 cases were of fracture of neck of femur, 4 cases had sacroiliitis and 4 cases revealed metastatic disease of hip joint. Of the 50 cases that presented with pain in hip joint, 26 cases showed radiographic findings. The rest 24 radiographs were normal.CONCLUSIONSRadiography is easily available and economical for imaging the hip joint. Radiography is the initial investigation for evaluation of joint pain. MRI is non-invasive. There is no radiation exposure. It is a valuable tool in diagnosing hip pain when radiography shows subtle or no findings. MR imaging is the most sensitive imaging modality for bone pain.

Role of colour Doppler in evaluation of venous abnormalities of lower limb

Background: Venous abnormalities of lower limb are a fairly common cause of morbidity. Although clinical diagnosis is the cornerstone of the diagnosis of lower limb venous disease, Colour Doppler ultrasound has become the investigation of choice to confirm the diagnosis. This study evaluated the role of Colour Doppler ultrasound in various venous pathologies of the lower limb and the sonographic findings were correlated with surgical and clinical findings.Methods: 100 patients of all age groups of either sex presenting with clinically suspected entities affecting venous system of the lower limb were selected for this study.Results: Our study showed a definite male preponderance (65%) with an incidence of 41% in the age group of 21-40 years. Isolated varicose veins had an incidence of 58% followed by isolated deep vein thrombosis (DVT) (29%), varicose veins with thrombophlebitis (5%), DVT with thrombophlebitis (5%), DVT with varicose veins (2%) and hematoma (1%). The findings correlated with surgery and gave a sensitivity of 100%.Conclusions: Colour Doppler ultrasound is unique due to its feasibility, accessibility and cost effectiveness. Its dynamism is also exploited by various maneuvers done by the patients, radiologist and the machine parameters to bring about changes in blood flow to reach the exact diagnosis.

Cystic variant of embryonal sarcoma of liver.

Embryonal sarcoma of the liver is an unusual tumor. The cystic form is rare and can mimic hydatid disease. We present a case that was mistakenly treated as a hydatid cyst for 3 months. Surgery was successful in removing the mass.