Diastematomyelia means sagittal division of the spinal cord into two hemi cords. It is a congenital malformation which results from an abnormal adhesion between ectoderm and endoderm. It is more common in females (3:1).
This abnormal adhesion which splits the cord may be in the form of fibrous tissue or purely a calcific bar or purely an ossific bar or even a combination of the earlier mentioned entities.
The health impacts of this entity are enormous, as the patients may be asymptomatic to begin with, until gradually; progressive spinal cord dysfunction sets in. Imaging plays a vital role in establishing the diagnosis and it may aid in easing the quality of life by making an early diagnosis.
The affected individual and the afflicted families need psycho-social guidance and counselling. We are presenting here, imaging findings in two cases of diastematomyelia.
Diastematomyelia; Imaging; Radiology; MRI; X-Ray; Ultrasound
With increase in population, modes of transportation and a fast pace of life, an individual’s chances of accident and thereby chances of getting fractured have increased significantly. Fracture has thus become a significant factor contributing to morbidity and mortality. To resume a normal life, after one suffers from a fracture is also an ordeal. The transition appears smooth if the fracture healing goes on in a smooth manner as is expected through its routine stages of reactive phase, reparative phase and remodeling phase. But if in this chain something goes wrong or some factors are not optimum upto the mark, then the process becomes unsuccessful and the repair is either partial or directionless. It is therefore very vital to confirm whether or not the callus which bridges the fractured fragments is healthy or not. Here in lies the role of imaging as it can show the status of callus without disturbing it. What complicates the picture is that a callus might not be well demonstratable unless it mineralizes or calcifies. An imaging modality like ultrasound therefore stands out as it can show the state of callus in its different stages. This article aims at demonstrating how ultrasound- a non invasive diagnostic imaging modality can give precise information about the progress of fracture healing and thereby aid in management of fractures, so that an individual can return back to normal productive lifestyle. This preliminary study highlights the spectrum of fracture healing as seen on ultrasound.
Fracture; Healing; Ultrasound; Callus; Mineralization; Vascularization
Intra-ocular calcifications can occur due to a variety of reasons. In cataract, the lovely lens gets calcified and the bright beautiful world becomes dark and dreadful. Cataract comes in various forms like; congenital, traumatic and senile. Asteroid Hyalosis (AH) occurs because of the accumulation of calcium soaps in vitreous of the eyes. Although it is asymptomatic and unilateral, it is seen more often in diabetic patients. Tumours of eye like retinoblastoma and optic nerve meningioma too are known to show calcifications. This review has focussed on imaging appearances of intra-ocular calcifications, a small process in a small organ that nevertheless has a wide impact on the entire organs.
Intraocular calcifications; Cataract; Asteroid Hyalosis; Retinoblastoma; Meningioma
Soft tissue calcifications and ossifications at distant sites have been reported as a sequel to head injuries or spinal cord injuries. They are usually noticed many months after injury, when once such bedridden patients try to be ambulatory, it rarely goes. Thus, they are an uncommon, disturbing and avoidable complication in patients who have injuries to central nervous system. Therefore, this article emphasizes on pathology, treatment options and finally, the preventive aspects.
Central nervous system; Heterotopic ossification; Injury; Range of motion
Calcifying tendinitis of the rotator cuff is a common disorder; its underlying mechanism still remains unknown. Although details of the clinical presentation(s) and pathological changes which are associated with calcific tendinitis are available, conservative management of this condition remains a topic of debate. About 90% of the patients can be treated non – operatively, but as some are resistant to conservative treatment; newer techniques or surgery should be indicated.
Rheumatologists and radiologists have often described this shoulder abnormality, leading to its progressive differentiation from other painful shoulder syndromes.
The conservative treatment includes the use of non – steroidal anti – inflammatory agents, roentegen therapy, physical modalities for controlling the pain and for preventing loss of joint mobility, local steroid injections, and open or arthroscopic surgeries.
Results of non – operative treatments have also been satisfactory. These include heat, cold, range of motion and pendulum exercises, diathermy, short – wave, and radiation therapy. Rest, immobilization with a sling, and oral non – steroidal and steroid anti – inflammatory medications have also been mentioned.
This review aimed at looking at calcific tendinitis of the rotator cuff with a wide vision in the light of modern advances; while at the same time, not disregarding the past experiences.
Calcific tendinitis of shoulder; Rotator cuff; Imaging; Plain radiograph shoulder; Conservative management
Lipoid Proteinosis (LP) is a genetically linked, autosomally transferred, rare, chronic multisystem disease which is characterized by a normal lipid profile, but with abnormal deposits of lipids and proteins in the body, which slowly but steadily leads to systemic manifestations. Although it affects almost all the systems of the body, it predominantly manifests as lesions on the skin and it has characteristic intracranial calcifications. Although, the intracranial calcifications can be classified, based on their aetiopathogenesis, as agerelated and physiologic, congenital, infectious, endocrine and metabolic, vascular, and neoplastic; the symmetric calcifications in LP are a distinct entity. To one who is aware of this entity, LP is usually an incidental diagnosis. No permanent cure is available for LP till date. Only symptomatic medical treatment is being given. With the increasing awareness on this entity, LP can now be detected in its early phase and it can be better managed.
As this condition is rare, it is necessary to spread awareness on this entity in the scientific community and hence this case is being reported. This case report is the first to demonstrate a novel association of an additional intracranial calcification in Lipoid Proteinosis.
Lipoid proteinosis; Intracranial calcification; Skin lesions; CT scan
Science is strengthened not by research alone, but by publication of original research articles in international scientific journals that gets read by a global scientific community. Research publication is the ‘heart’ of a journal and the ‘soul’ of science - the outcome of collective efforts of authors, editors and reviewers. The publication process involves author-editor interaction for which both of them get credit once the article gets published – the author directly, the editor indirectly. However, the remote reviewer who also plays a key role in the process remains anonymous and largely unrecognised. Many potential reviewers therefore, stay away from this ‘highly honorary’ task. Appropriate peer review controls quality of an article and thereby ensures quality and integrity of the journal. Recognising and rewarding the role of the reviewer is therefore vital. In this article, we propose a novel idea of Reviewer Index (RI), Reviewer Index Directory (RID) and Global Reviewer Index Directory (GRID), which will strengthen science by focussing on the reviewer, as well as the author. By adopting this innovative Reviewer Centric Approach, a new breed of well-trained reviewers of high quality and sufficient quantity will be available for eternity. Moreover, RI, RID and GRID would also enable grading and ethical rewarding of reviewers.
Author; Editor; Global reviewer index directory; Journal; Reviewer; Reviewer index; Reviewer index directory; Reward; Science
Reports about bilateral breast enlargement in patients on antiretroviral therapy are rare. It forms a constituent of the human immunodeficiency virus lipodystrophy syndrome. Often clinical suspicion followed by appropriate imaging evaluation is confirmative.
A case of antiretroviral therapy associated mastopathy is therefore presented here so that increased awareness would obviate the need of mastectomy in such cases. We also emphasise the role of adequate counselling in this scenario in alleviating patients’ anxiety.
Breast cancer; breast mass; mastopathy, antiretroviral therapy mastopathy; lipodystrophy
Primary breast tuberculosis is a rare entity in the developed world but is slightly more common in the developing world. All lesions that clinically, pathologically and imaging wise appear benign but do not respond to routine antibiotics, must be worked up for possible tubercular aetiology especially when they present as plain oedema, induration or as non-healing ulcers. Imaging has a role in defining the extent, deciding the type of management and duration of follow-up. This article highlights the clinical and sonographic imaging findings in one such case which was followed up for a period of one year.
Primary breast tuberculosis; ultrasound; acid fast bacilli; imaging
Diabetic mastopathy is the occurrence of lymphocytic mastitis and stromal fibrosis in men as well as women having long-standing diabetes. Clinical and radiological appearance can raise a suspicion of malignancy and result in unnecessary biopsy. As these lesions are known to recur; failure to recognise them can have devastating results. A case of diabetic mastopathy is therefore presented for the knowledge and benefit of all so that unnecessary surgery can be avoided.
Breast cancer; Breast mass; Mastopathy; Diabetic mastopathy; Diabetes mellitus; B-‐lymphocytes; Lymphocytic mastitis
The unborn healthy foetus is looked upon as a blessing by one and all. A plethora of thoughts arise in the brains of expectant parents. But what goes on in the brain of the yet unborn still remains a mystery. ‘Foetal mind’ is a reflection of functions of its organs of sense, an instrument of knowledge that may even be reduced to machine to demonstrate the effect of sense organs and brain contact. Testimony to this fact are the various waveform patterns obtained non-invasively from the foetal Middle Cerebral Artery (MCA) by using Colour Doppler Ultrasound. Our study, conducted for evaluating the foetal MCA in a rural obstetric population in Maharashtra, India, explains how the MCA - a major artery supplying foetal brain, can give abundant information about foetal heart and foetal stress. When only the foetal heart is stressed by the presence of arrhythmias or ectopic beats, these changes are manifest in the foetal MCA velocity waveform pattern as seen on Colour Doppler study. When the entire foetus is under stress, as in cases of intra uterine growth retardation (IUGR), changes again manifest in the foetal MCA velocity waveform pattern and are designated as the foetal Brain Sparing Effect. Thus scientific evaluation of foetal MCA waveform can objectively demonstrate that the overtly non-communicating foetal brain indeed remains an internal organ of sense and a vital instrument of knowledge to clarify the various effects of sense organs and brain contact. Although the brain parenchyma or cerebral metabolism has not been studied here, cerebral vessels serve as a window to cerebral metabolism, as auto regulatory function of brain leads to changes in haemodynamics of cerebral vessels. Also, like other vessels, MCA mirrors foetal distress and IUGR; but unlike other vessels, e.g. the umbilical or uterine artery, which show these changes in the form of reduction or even reversal of diastolic flow, MCA shows an increase in diastolic component due to brain sparing effect. The unique connection between physical changes in the foetal heart, brain and mental operations are thus critically clarified to some extent, and this helps untangle and comprehend the lattice of mental operations. Although this preliminary study has its limitations, it still carries forward the present corpus of knowledge on the strength of its evidential and critical enquiry and helps unravel the concept of foetal consciousness.
Brain; Colour Doppler ultrasound; Foetal distress; Foetal mind; Foetus; IUGR; KG waveform; Middle cerebral artery; Mind, pravara effect; Velocity waveforme
Telepathology has grown immensely due to rapid advances in information and technology. It has a wide variety of applications especially in the developing world, namely for remote primary diagnosis, specialist referrals, secondary opinions, remote teachings and in research. Basic infrastructure and skilled and experienced staff are the prerequisites for its successful implementation.
Socio-economic differences in developing nations result in a chaotic scenario so that, the advanced areas have expertise, while rural and remote areas remain deprived. Telepathology has the potential to bridge this gap.
This article discusses how successful use of the internet for telepathology is bridging this gap in developing nations and thereby contributing positively to effective healthcare. Possible constraints to telepathology and some solutions to overcome them are also discussed.
Internet; Healthcare; Telepathology; Telereporting; Developing nations
Congenitally defective metabolic pathways adversely affect the quality of life of patients as well as their care givers. Early diagnosis is therefore vital. Frequently, radio-imaging alone raises a strong suspicion and sometimes even provides conclusive evidence of defective metabolic pathways, when the patient presents with signs and symptoms that clinically fail to lead to a definitive diagnosis. This article discusses the role of radiological imaging that can lead to a strong suspicion, or even a diagnosis of these errors.
Congenital metabolic defects; radiograph; ultrasound; CT scan; MRI; MR spectroscopy