Radiology reporting of incidental osteoporotic vertebral fragility fractures present on CT studies: results of UK national re-audit.

AIM: To describe a UK-wide re-audit of the 2019 Royal College of Radiologists (RCR) audit evaluating patient-related data and organisational infrastructure in the radiological reporting of vertebral fragility fractures (VFFs) on computed tomography (CT) studies and to assess the impact of a series of RCR interventions, initiated to raise VFF awareness, on reporting practice and outcomes. MATERIALS AND METHODS: Patient specific and organisational questionnaires largely replicated those utilised in 2019. The patient questionnaire involved retrospective analysis of between 50 and 100 consecutive, non-traumatic CT studies which included the thoracolumbar spine. All RCR radiology audit leads were invited to participate. Data collection commenced from 1 April 2022. RESULTS: Data were supplied by 129/194 (67%) departments. One thousand five hundred and eighty-six of 7,316 patients (21.7%) had a VFF on auditor review. Overall improvements were demonstrated in key initial/provisional reporting results; comment on spine/bone (93.2%, 14.4% improvement, p<0.0002); fracture severity assessment (34.7%, 8.5% improvement, p=0.0007); use of recommended terminology (67.8%, 7.5% improvement, p=0.0034); recommendations for further management (11.7%, 9.1% improvement, p<0.0002). CONCLUSIONS: The 2022 national re-audit confirms improvements in diagnostic performance and practice in VFF reporting. Continuing work is required to build on this improvement and to further embed best practice.

Pseudomyxoma peritonei: a rare presentation as an umbilical nodule.

BACKGROUND: Umbilical nodules are rare and may be the sole presenting sign of an advanced intra-abdominal malignancy associated with poor prognosis. Metastatic involvement of umbilicus was first described in 1846 by Sister Mary Joseph, who established the correlation between carcinomas and umbilical nodes. AIM: We aim to describe a case report of Pseudo Myxoma Peritonei in a 31-year-old man who presented with subcutaneous non tender umbilical nodule. We also aim to emphasize the importance of differential diagnosis, when one encounters the presence of mucoid material in unusual sites such as the umbilicus. METHOD: Patient's clinical notes, operative findings, imaging studies, laboratory investigations including histopathology and immunohistochemistry were reviewed. A literature search was done to look into the incidence, pathophysiology, presentation and treatment options for this neoplastic process. CONCLUSION: PMP should be considered as one of the differential diagnosis when one encounters mucinous collection in unusual sites such as the umbilicus.