Anterior cruciate ligament graft tear primary and secondary magnetic resonance signs

Magnetic resonance [MR] imaging is a useful tool for assessing the anterior cruciate ligament [ACL] graft when its integrity is in question, with some limitations. It can differentiate between a graft that is partially or completely torn. Several primary [direct] and secondary [indirect] signs have been described. Graft continuity in the coronal plane and normal graft thickness in the coronal or sagittal plane are the most valuable primary signs in excluding full thickness tear. Of the secondary signs, the anterior tibial translation and the uncovered lateral meniscus sign are the most useful in differentiating a torn from an intact graft. Some of the primary and secondary signs of a native ACL tear are yet to be assessed for accuracy in detecting grafts tear, but they are a helpful guide especially when combined. These include the deep lateral femoral sulcus, the posterior cruciate ligament [PCL] angle, and the PCL curvature values

Mycetoma revisited, incidence of various radiographic signs

To define and quantitate various radiographic signs of mycetoma infection. A retrospective study of 516 randomly selected patients seen between December 1996 and December 2004 at the Mycetoma Research Centre of Khartoum University, Khartoum, Sudan. All cases were confirmed by clinical examination, initial pretreatment radiographs, and histopathology. The most common abnormalities in these 516 patients were soft tissue swelling [93%], bone sclerosis [56%], bone cavities [32%], and periosteal reaction [27%]. The incidence of bone expansion [22%], extrinsic cortical scalloping [22%], and fanning of the rays in 10% were reported. Osteoporosis was seen in 19%. Only 3% of the patients had normal radiographs. Maximal scrutiny of radiographs alone by experienced radiologists is vital, as other imaging techniques are not available where mycetoma is prevalent

Mycetoma of the hand

To describe the incidence and radiographic signs of hand infection in mycetoma. A retrospective review was carried out from the radiographic records of 516 confirmed cases of mycetoma seen between January 1994 and October 2002 at the referred outpatient clinic of the Mycetoma Research Center, Soba Teaching Hospital, Khartoum University, Khartoum, Sudan. The hands were involved in 24 [4.6%] of the 516 patients. The wrist was involved in 9 [1.7%]. Total involvement of the hand and wrist together was 33 [6.4%] of the 516 patients. Radiographic signs included fanning of the metacarpals, bone erosions, sclerosis, periostitis and soft tissue swelling. The most common sign was soft tissue swelling in 29 [88%] while bones were involved in 15 [45%] of the 33 patients. Hand infection in this series is less than previous reports. A wide range of radiographic signs is reported in hand mycetoma. This is the first detailed report of the radiographic findings in mycetoma of the hand. Early detection of mycetoma infection is important to avoid the need for amputation if diagnosis is delayed

Unnecessary x-rays: occurrence, disadvantages and side effects

Unnecessary use of radiodiagnostic tests is a cause for worldwide concern. As much as 20-30% of x-rays in Britain, Cananda and America were proved unnecessary. These unnecessary x-rays are assumed to cause 250 cancer deaths yearly in Britain and cost millions of pounds. All rich nations have embarked on restricting non-selective use of radiologic services. In Saudi Arabia there was no study for the ordering behavior of physicians for radiodiagnostic tests. The free access to primary and tertiary health care and the demanding nature of our patients can lead to the indiscriminate use of radiology services. This article addresses the problem of overutilization of x-ray tests and emphasizes the need for a national policy to reduce the biologic hazards and initiate a cost effective use of radiologic services. According to our own estimate a few hundred million Riyals could be saved by stopping unnecessary x-ray examinations

Diagnostic radiation of potentially reproductive females

To find out how consistent or variable is the understanding and practice of radiation protection procedures for women in the child bearing age at a multispeciality tertiary hospital. Riyadh Military Hospital Study. Design: Non-clustered population survey. A questionnaire was distributed during grand rounds, mid-day clinics and a radiology conference. Questions included which radiation protection rule does the respondent use for females, whether he or she is familiar with those rules and what is his or her source of reference. Further questions were about the radiation dangers to the fetus. Response was 95 [100%]. Fifty-seven [60%] were males and 38 [40%] were females. The majority 50 [53%] were Saudis, 16 [17%] Western and 29 [30%] were other nationals. Sixty-two [65%] followed the old rule 10-day rule; 17 [18%] followed the new 28-day rule and 16 [17%] didn't know which rule to follow. None of those who followed the 28-day rule indicated hospital policy as their reference. The understanding and practice of radiation protection guidelines for females is inconsistent. There is significant unfamiliarity with the radiation protection rules among our hospital practitioners