ABSTRACT
SummaryAlthough endocrine causes of secondary hypertension are relatively uncommon, medical practitioners must maintain a high index of suspicion for them in certain categories of patients. Such patients include young individuals, those with difficult-to-treat hypertension and those presenting with symptoms, clinical signs and/or laboratory parameters well-known to be associated with Cushing's syndrome, Conn's syndrome or phaeochromocytoma.This paper reports on 5 patients identified over a 2-year period with various hormonally-active adrenal adenomas causing hypertension in an environment where, hitherto, the occurrence of these conditions was generally thought to be rare. Aspects of the patients' histories, examination and laboratory findings that drew attention to the possibility of the diagnosis in each case are highlighted, as are the confirmatory investigations and management methods used by a multidisciplinary team of medical practitioners. The clinical outcome with appropriate treatment of adrenal-related hypertension is good and can result in significant cost savings in the long term.
ABSTRACT
BACKGROUND: Radiological investigations are central in the diagnosis and management of TB spine. In Ghana there is a dearth of literature on the disorder. This paper seeks to describe the CT features of the bony and soft tissue changes in Pott's disease. METHOD: It is a descriptive report of the CT scans performed on 30 patients with proven Pott's disease from January 1998 to December 2000 at the Korle Bu Teaching Hospital Accra, Ghana. RESULTS: The disorder was common among children and young adults (76.7%). Chronic back pain was the frequent presenting complain (53.3%). The dorsal spine remains the site of preference while T11 recorded the highest incidence (73.3%). The vertebral body was destroyed in all the cases and the fragmentary type of bone destruction was the common observation. The incidence of cord compression demonstrated by CT was high (73.3%). Other findings were paraspinal and epidural masses observed in (66.7%) and (73.3%) respectively. CONCLUSION: CT images demonstrated the spinal level of destruction. Improved resolution also showed detailed changes within the outlined soft tissue masses, facilitating early diagnosis and prompt initiation of therapy.
