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Abstract: Syndromic Multifocal non-ossifying fibromas have been reported in patients with the Jaffe–Campanacci syndrome and in patients with Type 1 neurofibromatosis[1-3]. Evans and park reported a rare case of three members of a family with the existence of multiple, symmetrical, non-ossifying fibromatosis without associated neurofibromatosis [5]. Here we report a rare case of non-syndromic multiple non-ossifying fibromas. A 23-year-old male complained of bowing deformity in the Right knee for 10 years. The deformity was insidious in onset, gradually progressive on nature, and made him sit with a wide base. Initially, the base was non-progressive with minimal distance between the two feet but now the distance has increased to the length of a brick. There was no history of pain, trauma, or difficulty to perform routine activities. On examination, Genu Valgum of Right knee was diagnosed and the disappearance of Deformity was noted during flexion of the knee. There were no Café-au-lait spots or other signs of neurofibromatosis. Radiograph of the Knee revealed lucency in the distal end of the Right femur. Differential diagnoses considered were Fibrous cortical defects and Non-ossifying Fibromas. MRI of the Right knee revealed multiple well defined bubbly lytic lesion with sclerotic margin and eccentrically along the cortex in the distal femur. A similar lesion was seen in the proximal tibia. Later bone curettage was performed and histopathology examination revealed findings consistent with non-ossifying fibroma.Here we present a rare case of non-syndromic multiple non-ossifying fibromas.

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Abstract: A persistent left superior vena cava is found in 0.3- 0.5% of the general population and in 4-7% of patients with congenital heart disease. Approximately 50% to 70% of these patients are at risk of paradoxical embolism because of accompanying lesions (e.g., interatrial septal defect, unroofed coronary sinus, or direct communication of the vein to the left atrium).

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Abstract: Tuberculosis (TB) is a leading cause of mortality worldwide with increasing mortality rate. The pleura is a common extra pulmonary site of involvement and it is the most common form of extra pulmonary TB only less frequent than lymph nodes involvement. All age groups can be affected by TB. Tuberculous involvement of the pleura usually presents as pleural effusion, empyema or pleural thickening. Rarely, it can present as a pleural mass with or without lung parenchymal involvement. This case is presented to highlight the role of imaging especially plain x-ray and computed tomography to resolve the confusion.

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Abstract: Cystic ectasia of the rete testis is a rare condition. The diagnosis is mainly based on ultrasound. We report a case of bilateral tubular ectasia, more marked on the left of a 31-year-old patient.

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Abstract: Background: Ultrasound is used to evaluate the LUS, especially if there is a previous scar, and it is more beneficial to predict the possibility of the occurrence of any complications during labor either by repeated cesarean section or by vaginal delivery. Material and Methods: A total of 50 pregnant patients were included in this study. Transabdominal ultrasound was done for scarred uteri. Sonographic findings were co-related with introperative findings. All the given data were entered on SPSS version 23. Age was expressed as mean ± SD. Parity, gestational age, and interval between cesarean sections were expressed as frequencies with percentages. Statistical analysis was done by using Chi-square test for categorical data for association between sonographic scar thickness and intraoperative findings. The statistical significance was set at p-value e <0.05. Results: The mean age of study group was 28.27 ± 3.32 years. The minimum age was 18 years and maximum was 39 years. Maximum number of patients (65%) had 13-24 months interval between previous and current pregnancy. No patient had interval more than 48 months. The mean scar thickness in study group was 3.24 mm ± 1.3 mm. Minimum scar thickness on TVS was 1.2 mm and maximum was 6 mm. Among all, maximum (34.0%) number of patients had scar in range of 3.1-4.0 mm. Mean scar thickness on MRI was 3.6 mm± 1.23 mm. Minimum scar thickness measured on MRI seen was 1.7 mm maximum thickness measured was 5.6 mm. Similar to TVS findings maximum (32.0%) patients had scar thickness seen in range of 3.1-4.0 mm. In 82.0% cases scar was intact and scar thickness was measured using calliper while in 14% cases scar was dehiscent. Conclusion: MRI offers no advantage in diagnostic accuracy for the measurement of LSCS scar thickness during consideration of TOLAC.

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Abstract: Background: Nonalcoholic fatty liver disease ranges from simple steatosis, steatohepatitis—to advanced fibrosis and cirrhosis. It has great significance in medical practise as an increasingly recognized condition globally. Early detection and quantification to prevent its sequelae is necessary. Aims: We are keen to investigate minimally invasive technique to bring for the clinicians, a socio-economic issue of importance to the field of Radiology. Objective: To compare ultrasound with MRI for the diagnosis of liver steatosis. Methods: A prospective study was carried out at Radiology Department, IDC. Study duration: November 2018 - May 2019. 86 participants, aged 14-86 years, of either gender, with suspicion of steatosis were selected, after satisfying inclusion and exclusion criteria. Steatosis was confirmed utilizing Complex-based technique with MRI. For ultrasound, conventional sonographic signs criterion was used. Results: 88 consecutive patients, (43 females and 45 males) mean age (48.88 years). MRI-PDFF revealed steatosis grade 0 (normal) in 40.9% cases, 35.2%, 18.2% and 5.7% in grade 1, 2 and 3 accordingly. While ultrasound revealed grade 0 in 26.1% cases and 44.3%, 25% and 4.5% in each respective grade. Sensitivity of ultrasound amplified as amount of hepatic fat gradually increased, from 58.33% (minimal steatotic cases) to 93.75% and 100% respectively (moderate to severe cases). Specificity remained between 73.68% to 98.82% throughout all cases. Conclusion: Ultrasound correlated well with MRI in moderate to severe hepatic steatosis, with mild degrees its specificity is reduced owing to other causes of liver injuries. Subjects practising unhealthy diet, hypertensive plus diabetics are more prone to develop steatosis. Thus its an acceptable modality for steatosis diagnosis, if severity/grading is neglected.

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Abstract: Background: Aim of this study was to investigate the potential influence of Critical Shoulder Angle (CSA) as a predisposing factor for the development of degenerative full-thickness rotator cuff tears (DRCT) or primary glenohumeral osteoarthritis (PGOA). Materials and Methods: This was an observational and prospective study, with subjects presenting with pain and/or restricted motion of their shoulder/s (symptomatic shoulders) presenting to the orthopedic Department and Radiology, Subbaiah Institute of Medical Sciences conducted between December 2019 to August 2020. We divided the subjects into case and control groups on the basis of presence and absence of “non-traumatic RCTs,” respectively, as per their USG (in three patients) and/or MRI shoulder scans. There were 60 study subjects and 60 control subjects. Results: The mean age of the control group was 56.37 years, while that of the study group was 58.42 years. The study group had a predominance of males (58%). About 62% of subjects in the study group had right-sided symptomatic shoulders. The mean CSA of control subjects was 32.63° (±1.87°), while that of study subjects were 36.72° (±2.24°). The minimum and maximum CSA values in the study and control groups as well as their mean, median and mode, with standard deviation. Mean CSA values of study and control groups are represented. Conclusion: The CSA was an objective assessment tool to identify patients with shoulder pain who may have RCTs. Our study indicated that the CSA predicted RCTs more accurately than did the AI for patients with shoulder pain.

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Abstract: Calcifications of the prostate are frequent and benign. They are not linked to any particular symptom or disease. They are not precursors of prostate cancer. We evaluated in 78 patients, the characteristics of these calcifications and their prevalence according to the presence of urinary symptoms.

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Abstract: To assess the severity of acute pancreatitis (AP) using computed tomography (CT) severity index (CTSI) and modified CT severity index (MCTSI), to correlate with clinical outcome measures, and to assess concordance with severity grading, as per the revised Atlanta classification (RAC). Material and Methods: This is a prospective and descriptive study conducted in the Department of Radiology at a Maheshwara Medical College. A total of 50 patients enrolled with the chief complaint of epigastric pain, nausea and vomiting and CECT abdomen were suggestive of acute pancreatitis were included in this study. Assessment of severity of acute pancreatitis was done in all cases by Balthazar CTSI scoring and Mortele Modified CTSI scoring. Results: In our study total 50 cases of acute pancreatitis cases were included in the study. Out of 50 cases, 36 (72 %) were male and 13 (26%) were females. We found that acute pancreatitis was found three times more common in males than in females. Cholelithiasis was found to be most common aetiological factor for acute pancreatitis in 48% cases followed by alcoholic pancreatitis was seen in 26% of cases. Least Aetiological factor such as Trauma and drug induced. Pleural effusion was the most common extra-pancreatic complication, 27 patients (54%). Left pleural effusion was more common than the right, and in none of the cases, isolated right sided pleural effusion was found. Ascites was the second most common complication seen in 9 patients (18%). Conclusion: In conclusion CECT was found to be an excellent imaging modality for diagnosis, establishing the extent of disease process and in grading its severity. The Modified CT Severity Index is a simpler scoring tool and more accurate than the Balthazar CT Severity Index. In this study, it had a stronger statistical correlation with the clinical outcome, be it the length of hospital stay, development of infection and occurrence of organ failure. It could also .....................

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Introduction: Ultrasound is commonly used as a tool for investigation of acute appendicitis in children. The accuracy of ultrasound in appendicitis depends on the ability to visualize the appendix and the potential contribution from secondary signs. The study was a retrospective analysis of children referred for sonographic investigation of possible acute appendicitis at an Australian tertiary pediatric hospital between January 2008 and December 2010. Material and Method: The present study was conducted on 100 pediatric patients with possible diagnosis of appendicitis at Department of Radiology, Shadan Institute of Medical Sciences, Teaching Hospital & Research Centre, Hyderabad. Over a period of one year. All of the patients underwent initial clinical evaluation followed by ultrasonography (USG), which was used to assess the existence of signs associated with appendicitis or its complications. USG Imaging findings were then compared in patients with and without complications. False positive, false negative, true positive and true negative values were calculated. Sensitivity and specificity of ultrasonography in determining appendicitis was evaluated. Results: Of the 100 pediatric patients, 65 (65%) were male and 35 (35%) were female. There were also 65 (65%) true positive and 35 (35%) true negative cases based on ultrasonography findings. In our study, USG sensitivity was 83.6%, specificity was 80.6%, positive predictive value was 94.4%, and negative predictive value was 80.6%. Conclusion: Ultrasonography is indicated in the diagnosis of appendicitis in pediatric patients and has optimal sensitivity and specificity in the diagnosis. Furthermore, it is a suitable diagnostic method for evaluating complications of appendicitis.

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Background: Hypoxic-ischaemic encephalopathy in adults and older children (i.e. not neonates), also known as global hypoxic-ischaemic injury, is seen in many settings and often has devastating neurological sequelae. Magnetic Resonance imaging—has the potential to play a significant role in diagnosis and early intervention in cases of HII. In addition, imaging studies performed in the subacute stages of injury provide information on the severity and extent of injury and can be helpful in predicting long-term outcome. Material and Methods: This prospective study was conducted in a Department of Radiology, Shadan Institute of Medical Sciences, Teaching Hospital & Research Centre, Hyderabad over a period of 1 year. A total of 70 patients with history of birth asphyxia were included in the study who underwent MRI of brain and were followed up clinically at the end of one year to assess the neurological outcome. Result: Of the 65 babies, 43 were males and 22 females, which correspond to 66.1% of male and the rest female babies. Maximum patients, i.e., 53.8% (n = 35) were having Apgar score of 4-6 followed by ≤3 score was 29.2% and least were > 7 score were 16.9%. In HIE 2 cases, 32.3% had involvement of corpus callosam. 24.6% had PVL, 16.9% had basal ganglia or thalamus lesion. There was no MRI evidence of HIE in 26.1% Conclusion: HIE is an important cause of morbidity and mortality in the neonatal period. MRI show characteristic pattern of brain injury and help to exclude other causes of encephalopathy. Imaging plays an important role in early diagnosis and timely intervention, thereby reducing the severity of neonatal brain injury.

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Background: Abdominal trauma is a common reason for presentation to the emergency department (ED). Abdominal trauma is classified as either blunt or penetrating. Penetrating abdominal trauma is easily diagnosed, while blunt trauma complications can be missed if the clinical signs are not evident. Ultrasound in the evaluation of abdominal trauma has evolved over the past 30 years. This study aims to assess the role of focused sonography in early diagnosis of abdominal injuries following blunt abdominal trauma and follow up in patients with intra-abdominal injury for early diagnosis of complications. Material and Methods: This is a prospective and observational study conducted in the Department of Radiology at Dr. VRK Women's Medical College over a period of 6 months. Including all patients with age ≥18 years of either gender with a history of blunt trauma abdomen (BTA) presenting to the Emergency Department. Patients with overt/obvious signs of peritonitis were excluded. Abdominal ultrasonography was performed in the emergency department during initial evaluation and resuscitation. Ultrasonography was performed by sonographers who were trained in trauma ultrasonography and were registered diagnostic medical sonographers. The sonographers used either an Acuson XP 10-128 or Acoustic Imaging 5200S ultrasound with 3.5-MHz and 5.0-MHz probes.