Incidentalomas in Chest Radiograph of Apparently Healthy Individuals Presenting for Pre-Employment Medical Examination in Enugu State, Nigeria.

BACKGROUND: A chest radiograph is the most commonly requested and performed imaging for diagnosis and screening including medical examination. AIM: The study aimed to determine the prevalence and pattern of incidentalomas in radiographs of cases presenting for pre-employment medical examination. METHODS: This was a retrospective review of chest radiographs conducted for patients presenting for pre-employment medical examination from January to December 2022. Relevant data including sociodemographic characteristics, clinical details and chest radiograph reports were retrieved using study proforma from all patients with complete medical data were analyzed using statistical package for social sciences (SPSS) version 23 with the level of statistical significance set as P <0.05 taken as statistically significant. RESULTS: Three hundred and eleven chest radiographs of subjects aged 20-49 years were evaluated, of which 22 (7.1%) incidentalomas were found. Most were females (55%). Of these incidentalomas, 12 (54.6%) were in the cardiovascular system, while the skeletal and pulmonary systems accounted for eight (36.4%) and two (9.1%), respectively. In all participants, clinically significant findings were eight (2, 6%), comprising of cardiomegaly five (1.6%), leash of vessels in the upper zone one (0.3%), blunt costophrenic angle one (0.3%), and right-sided aortic arch one (0.3%). Age and gender have no statistical significance in the incidental findings. CONCLUSION: Although the incidence of clinically significant incidentalomas appears low in our environment where beliefs and lack of adequate healthcare financing prevent the majority from seeking timely medical attention, chest radiograph remains an invaluable tool for pre-employment medical examination. Some underlying medical conditions could be picked up, further investigation sought to save life, and it serves as a baseline with which future findings may be compared.

The prevalence of cervical ribs in Enugu, Nigeria.

BACKGROUND: Cervical rib is an important cause of nontraumatic thoracic outlet neurovascular compression. This study was undertaken as there is no known documented report on its prevalence in the study environment. AIMS: To evaluate the prevalence of cervical ribs and its variation with sex and age among patients presenting at radiological facilities for a chest radiograph. SETTINGS AND DESIGN: Retrospective evaluation of plain posterior-anterior view chest radiographs done in radiological facilities in Enugu, Southeast, Nigeria. SUBJECTS AND METHODS: Evaluated in this study were all 6571 chest radiographs consecutively obtained between 2009 and 2012 in three randomly selected radiological facilities in Enugu. STATISTICAL ANALYSIS USED: SPSS version 17 software was used in data analysis. Chi-square and student t-tests were used to test for the significance of findings at 95% confidence level. RESULTS: This study reports the overall prevalence of cervical ribs as 48 (0.7%) with a significantly higher rate in females 43 (1.1%) when compared to males 5 (0.2%) (P = 0.000). In 27 (0.4%) cases, the cervical ribs were bilateral; whereas in 21 (0.3%) cases, they were unilateral with 8 (0.1%) on the left and 13 (0.2%) on the right. There was no age-related variability with prevalence (P = -0.813). CONCLUSIONS: The prevalence of cervical rib in the study population is low and within the known range as seen in other geographical regions of Nigeria.

Use of fetal biometry in the assessment of gestational age in South East Nigeria: Femur length and biparietal diameter.

BACKGROUND: Fetal growth is influenced by many factors such as race, socioeconomic status, genetics, geographical location, maternal diseases, and number of babies. Consequent upon these, fetal growth charts may vary from one location to another even within the same geographical entity. OBJECTIVE: This study was designed to establish the fetal growth chart in antenatal women who had ultrasound scanning at the University of Nigeria Teaching Hospital, Enugu, South East Nigeria. PATIENTS AND METHODS: This is a descriptive analysis of fetal biometric measurement of antenatal women. Four hundred and seventy pregnant women were studied. RESULTS: The nomogram for the femur length (FL) and biparietal diameter (BPD) for the different weeks of gestation (from 13th to the 40th week) were established. Correlation coefficients between gestational age and the various fetal parameters were also reported. Growth charts using both FL and BPD were plotted. A regression model for prediction of fetal age using the fetal biometry was also deduced for the studied population. CONCLUSION: The fetal parameters used in this study were consistently smaller than reported values from European studies up to the 34th week of gestation after which a catch-up growth till the 40 weeks was observed. Fetal parameters observed in this study were larger than most of the reported Asian values.

Sonographic analysis of adult polycystic kidney disease: retrospective data from South-East Nigeria.

BACKGROUND: Autosomal dominant polycystic kidney disease (APKD), an inheritable multisystem disease characterized by intrarenal and at times extrarenal disease, has been studied extensively among Caucasian populations. Despite the fact that being black is a risk factor for progressive disease, there is paucity of local published data. As a result, true local incidence and peculiarities in clinical and sonographic characteristics are unknown. AIM: To present data from 19 patients diagnosed with APKD in a medium-sized facility over a 16-year period. MATERIALS AND METHODS: A retrospective search was done on the ultrasound registers for patients who had undergone abdominal ultrasound in 16 years (1997-2013). Of the 29 sonographic diagnoses of bilateral PKD made, only 19 had complete records and were included in the study. Data extracted were- age, sex, working diagnosis, renal size, diameter of renal cysts, presence or absence of extrarenal cysts, family history of renal cystic disease, blood pressure at diagnosis, and patient outcome. RESULTS: A total of 19 diagnoses of APKD were made- 12 males and seven females with a sex ratio of 1:0.6. Total mean age was 54.8 years (range 31-79 years)- 40.1 years for females and 57.2 years for males. In 89.5% of cases, no family history of APKD was obtained. Only six (31.6%) patients were hypertensive at presentation and three patients (16%) were already in renal failure. Ultrasound showed a mean renal size of 88.92 cm² for the right kidney and 98.97 cm² for the left. Mean cyst diameter was 3.46 cm (range 2.08-4.85 cm). Only one patient had documented extrarenal cystic disease. Two patients were lost to renal failure and congestive cardiac failure. CONCLUSION: APKD appears to be uncommon in our environment; however, more studies may be elucidatory. Standard sonographic protocol for collecting data from patients with APKD is needed.

Sonographic Analysis of Adult Polycystic Kidney Disease: Retrospective Data from South-East Nigeria

Background: Autosomal dominant polycystic kidney disease (APKD); an inheritable multisystem disease characterized by intrarenal and at times extrarenal disease; has been studied extensively among Caucasian populations. Despite the fact that being black is a risk factor for progressive disease; there is paucity of local published data. As a result; true local incidence and peculiarities in clinical and sonographic characteristics are unknown.Aim: To present data from 19 patients diagnosed with APKD in a medium-sized facility over a 16-year period.Materials and Methods: A retrospective search was done on the ultrasound registers for patients who had undergone abdominal ultrasound in 16 years (1997-2013). Of the 29 sonographic diagnoses of bilateral PKD made; only 19 had complete records and were included in the study. Data extracted were- age; sex; working diagnosis; renal size; diameter of renal cysts; presence or absence of extrarenal cysts; family history of renal cystic disease; blood pressure at diagnosis; and patient outcome.Results: A total of 19 diagnoses of APKD were made- 12 males and seven females with a sex ratio of 1:0.6. Total mean age was 54.8 years (range 31-79 years)- 40.1 years for females and 57.2 years for males. In 89.5 of cases; no family history of APKD was obtained. Only six (31.6) patients were hypertensive at presentation and three patients (16) were already in renal failure. Ultrasound showed a mean renal size of 88.92 cm 2 for the right kidney and 98.97cm 2 for the left. Mean cyst diameter was 3.46 cm (range 2.08-4.85cm). Only one patient had documented extrarenal cystic disease. Two patients were lost to renal failure and congestive cardiac failure.Conclusion: APKD appears to be uncommon in our environment; however; more studies may be elucidatory. Standard sonographic protocol for collecting data from patients with APKD is needed

Sonographic assessment of the normal limits of the spleen in healthy school children in South-East Nigeria.

BACKGROUND/OBJECTIVE: Ultrasonogrphy is a good modality for the detection of splenomegaly even when it is not clinically palpable. The objective of this study was to establish the normal values of splenic length in healthy school children in South-East, Nigeria and to correlate them with body indices. MATERIALS AND METHODS: This is a cross-sectional prospective study of 1315 children (633 boys and 682 girls) between the ages of 5 and 17 years. The splenic length was measured between the most superiomedial and the most inferiolateral margins, at the level of the hilum. Only the spleens that had normal shape and echotexture were measured. The mean splenic length and the 5 th and 95 th percentiles were determined for each age. The length was correlated with the sex, age, weight (WT), height, body mass index (BMI) and body surface area (BSA) of the subjects. A regression model for prediction of spleen dimension from age and body habitus was computed. RESULTS: There was a significant correlation between splenic length and age, P < 0.001. Males had statistically significant longer spleen length than females. The splenic length correlated best with BSA, followed by body WT and least with BMI. CONCLUSIONS: This study noted racial variation between the established Nigerian values and results from other countries of the world. For the first time, a baseline value for splenic size for the Nigerian Children of various ages has been established with a regression model for predicting the splenic sizes.