BARODA MEDICAL COLLEGE RADIOLOGY

ULTRASOUND IMAGING IN OBSTETRICS AND GYNAECOLOGY

2021-08-23T22:30:00.001-07:00

A PRESENTATION ON ULTRASOUND IMAGING IN OBSTETRICS AND GYNAECOLOGY (FOR UNDERGRADUATES)

BATCH OF 2018

2021-07-27T20:30:00.001-07:00

THE BATCH OF 2018 HAVE PASSED - ALL 6 M.D. CANDIDATES.

It was long endearing 3 years of residency and all of them passed with flying colors.

We wish them best of luck for their futures endeavors.

BATCH OF 2018 : FROM LEFT TO RIGHT DR. NIRJA DESAI, DR. NIRALI MEHTA, DR. DISHA BHARPODA, DR. GIRISH PARMAR, DR. SACHIN PATHARE, DR. ASHWINI JOSEPH.

MARATHON ACHIEVER - DR. BHARTAN KHARADI (ASSOCIATE PROFESSOR)

2021-07-20T06:36:00.002-07:00

DR. BHARTAN KHARADI - MARATHON ACHIEVER

"Finishing a marathon isn't a athletic achievement. It is a state of mind; a state of mind that says anything is possible"

"When your legs can't run anymore, run with your heart."

DRAWINGS BY DR. SACHIN PATHARE (RESIDENT)

2021-07-20T06:30:00.002-07:00

DRAWINGS BY DR. SACHIN PATHARE (RESIDENT)

A SHOWER OF MEDITATIONS

CHANGE - A THOUSAND DEATHS

GLOW

JOKER- Joaquin Phoenix

INTO MY EYES

THE CLIMAX

OUR COVID WORK

2021-07-01T07:10:00.001-07:00

APPRECIATION OF OUR COVID WORK IN LOCAL NEWSPAPERS

NEW MOBILE DIGITAL RADIOGRAPHY SYSTEM - SAMSUNG GM-85

2021-05-31T02:34:00.003-07:00

DONATED BY SAMSUNG INDIA ELECTRONICS PVT. LTD.

Ultimate Driving Experience – Going anywhere with advanced mobility
The “GM85”, a premium mobile Digital Radiography (DR) system provides exceptional mobility, enhanced user-convenience and a high image quality to meet the demands of today’s radiographers and radiologists. GM85 is powered by 32Kw , High frequency generator delivering 500mA output and fully battery operated for ultimate driving experience, enhanced mobility and streamlined workflow, enabling the users to experience a new level of efficiency with a mobile DR system without jeopardizing image quality. The Whole unit is powered by the latest Lithium Ion Polymer Batter for long life and Quick charging.

The key features of the GM85 include:

Easy Navigation with Compact Design

Ultra-compact Design — 555mm narrow width and weight of 349kg, it allows easy access around tight spaces, even in elevators.

Collapsible Column — Gives users clear visibility when moving the system and helps access anywhere easily.

Adaptive Soft Driving Control & Front Bumper Sensor — Offer safe navigation and an ultimate driving experience.

Optimized Workflow with Enhanced Usability

SID (Source to Image Distance) Guide — Supports detailed device positioning with multiple SID settings.

S-Align — Displays the detector’s angle to the THU (Tube Head Unit) for precise alignment to enhance image quality.

Quick-Positioning — Allows handle-free, precise body movement by simple button clicks on the THU and optimizes workflow, enabling users to save time.

Quick Charging & Long-lasting Battery — Improve work efficiency by powering up to 100% in only two to four hours and going on for all day.

CLICK HERE TO VISIT OFFICIAL WEBSITE

NEW ULTRASOUND MACHINE IN DEPARTMENT - SAMSUNG RS80 EVO

2021-05-31T02:19:00.003-07:00

SAMSUNG RS80EVO

DONATED BY SAMSUNG INDIA ELECTRONICS PVT. LTD.

SAMSUNG RS80Evo PREMIUM RADIOLOGY ULTRASOUND SYSTEM ARCHITECTURE:

23” HD LED Monitor with resolution of 1920x1080x24 bits
13.3” LCD (LED backlight unit) Tilting Touch Screen
6 Probe ports (including pencil Probe port)
6 Probe holders
Gel warmer
Digital TGC controls on touch screen
DDR3 SD RAM 16 GB
HDD : Integrated SSD (512 GB)
6 way moving and motorized console movement.
SAMSUNG RS 80Evo APPLICATION INCLUDES;
Abdomen
Obstetrics
Gynecology
Urology
Vascular
Small Parts
Pediatric
Musculoskeletal
Contrast
Cardiac
TCD
Samsung RS80Evo Premium Radiology Ultrasound System uses newly developed S-Vision architecture, S-Vue transducer resulting in superb Image Quality for accurate diagnosis;

S-Vision Beamformer
The S-Vision Beamformer is the 1st step in acquiring high-resolution images for accurate diagnosis. The most ideal signal is transmitted with less side lobes, resulting in reduced noise and less artifact while, at the same time providing remarkable image quality.
S-Vision Imaging Engine
With the advanced technology built on the RS80Evo system, the digital signals received from the Beamformer demonstrates clear, detailed resolution and tissue uniformity for all types of applications in general imaging.
S-Vue Transducer
The extremely responsive S-Vue transducer provides broader bandwidth and higher sensitivity. In combination with S-Vision Beamformer technology and the S-Vue transducer, hard to visualize pathology
is more easily demonstrated. The technically challenging patient is easily scanned delivering superb resolution at depth. In addition, the small ergonomically designed light-weight transducer enables users to suffer less fatigue.
RS80Evo increases confidence with accurate results using advanced technologies developed by Samsung, while simultaneously enhancing user convenience and providing an efficient work environment.
PRECISE GUIDANCE ASSISTS IN ACCURATE NEEDLE PLACEMENT
Advanced QuickScan™
Advanced QuickScanTM technology maximizes workflow and efficiency, therefore enables users to remain focused on the patient. With a simple touch of a button important imaging parameters are automatically adjusted, such as color gain, location of the color box and angle correct. This feature improves workflow and increases efficiency.
Low-MI (Contrast-Enhanced Ultrasound) ((Option)
Low-MI is a technology that uses contrast agents when performing ultrasound scans. This technology processes reflected signals from contrast agents, which are stimulated by particular ultrasound pulses, and produces a unique sonogram with increased contrast. Exams are easier to perform by providing dual-live views.

Realistic Vue™ (Option)
Realistic Vue™ is a 3D/4D technology that displays detailed volume rendering, which enables users to easily identify subtle anatomical features. Anatomies look realistic when viewed in color with shading that provides additional depth perception, helping users better define the complex structures of anatomies which is almost impossible in 2D.
E-Breast™ (Option)
Using a streamlined work process, E-BreastTM technology calculates the strain ratio for the lesion. This simplified process of just selecting on 1 ROI enhances usability and improves examination efficiency.
E-Thyroid™ (Option)
The E-Thyroid technology provides a more objective diagnosis by using an elastography index to determine the strain ratio of nodules. ElastoScanTM images are acquired by using the pulsation of carotid artery.
2D-Shearwave Imaging Elastoscan (Option)
S-Shearwave Imaging™ allows for non-invasive assessment of the stiffness of tissue/lesions in the breast and liver, by providing an advanced level of diagnostic information. The color-coded elastogram, quantitative measurements (in kPa or m/s), dual or single display option, and user-selectable ROI (position and size) functions are especially useful for the accurate diagnosis of breast and liver diseases.

Click here to visit official website

ACHONDROPLASIA

2021-05-16T07:27:00.000-07:00

A 2 year old male child presented with features of retarded growth in the form of short height (height below 5th percentile). Altered upper to lower segment ratio and large head. However the child had normal intelligence.

Anchondroplasia is one of the oldest recorded growth disorders in ancient times. These individuals were kept as entertainers to the wealthy. Only since 19th century people with achondroplasia are known to be normal, except for their physical appearance.
It’s prevalence ranges from 0.36 to 0.6 per 10,000 live births.
Most obvious is their stature which averages approximately 50 inches. Characteristics can be recognized antenatally and at birth. Long bones are shortened, especially proximal ones (rhizomelic shortening). Cranium is large with prominent forehead and depressed nasal bridge. Base of skull is constricted with small foramen magnum which can lead to hydrocephalous ,cord compression and even sudden death.
The tubular bones of hands and feet are short and thick. The fingers are all of same length with separation of middle and ring fingers (trident hand). Ribs are quite short and donot extend around the thorax. Scapula may be squared inferiorly with a shallow glenoid.
Pelvis is small, ilia are shot and flat with small sciatic notches. Acetabular roof is horizontally oriented with thickening of the Y cartilage giving Champagne glass appearance of pelvis.
Symmetric shortening of all small bone with proximal bones being most affected. Flared bone ends with metaphyseal cupping is also seen.
In lumbar spine, there is progressive decrease in interpedicular distance caudally. Posterior scalloping of vertebral bodies and bullet nosed vertebrae may also be seen.

COMPLICATIONS:
Unexpected infant death and death risk (7.5%) due to respiratory dysfunction from brain stem compression at the cranio-cervical junction.
Other reported associations are chronic otitis media, conductive hearing loss, delayed speech, relative adenotonsillar hypertrophy, orthodontic problems, heart disease, spinal stenosis, jugular foramen and hypoglossal canal stenosis.

GIANT CHOLEDOCHAL CYST - TYPE I

2021-05-16T05:40:00.006-07:00

A 5-years-old girl presented with progressive abdominal distension since past one month. There was no associated history of jaundice, fever, vomiting or bowel complaints. she was anicteric and mild pallor was noted. Laboratory values were: Hb- 10.9 g/dL, total bilirubin-1.1 mg/dL, SGPT-38 IU/L, SGOT-35 IU/L.

On examination a large, soft, non-tender lump was palpable in the right hypochondrium, extending to the right iliac fossa and umbilical region. The lump had a smooth surface and was continuous with liver dullness. She had non palpable spleen, no ascites and all other systems were found to be normal

DISCUSSION:

Choledochal cysts are classified according to the Todani modification of the original Alonso-Ley classification. five groups are identified. Type I is a fusiform dilatation of the extra hepatic bile duct, as was found in our patient. Type II is a single extrahepatic diverticulum. Type III is a dilatation of the intraduodenal portion of the bile duct. Type IV consists of two subtypes: IVa which is combined intra- and extrahepatic dilatation and IVb which is multiple extrahepatic cysts only. Type V is also known as Caroli’s disease and consists of cystic dilatation of the intrahepatic biliary system. It is also associated with hepatic fibrosis.

The etiology of choledochal cysts remains unproven but an anomalous pancreaticobiliary junction has been reported in choledochal cyst disease. Babbit proposed a theory that suggests a high insertion of the bile duct into the pancreatic duct allowing pancreatic enzymes to reflux into the bile duct. This causes inflammation, weakening and fibrosis of the bile duct and the distal obstruction leads to progressive dilatation of the biliary tree. Children present with the classic triad of abdominal mass, abdominal pain and jaundice.

Laboratory tests have not been proven to be useful in establishing a diagnosis and it has been shown that hepatic transaminase, bilirubin and white cell count were normal in up to 50% of patients at time of diagnosis. Imaging however is essential in making a diagnosis. Ultrasound and CT are useful for detecting cysts, but differentiation from other fluid collections and confirmation of the biliary origin of the cyst can sometimes be difficult. Direct contrast cholangiography is used to define extent of involvement and visualize the remaining biliary tree. Contrast cholangiography is invasive though, and magnetic resonance cholangiography (MRCP) is a non-invasive technique, accurate in confirming the diagnosis of choledochal cysts and defining extent of involvement pre-operatively.

There is an increased risk of malignancy in choledochal cysts and the occurrence of cancer is most marked in adults. Type I has the highest predominance of cancer, followed by the type IV cyst. The type III cyst is the least common type harboring cancer. Most of the tumors found are adenocarcinomas, although squamous and anaplastic cell carcinomas are occasionally discovered. The most common site of occurrence is the posterior cyst wall. Prognosis is poor and most patients die within 2 years of diagnosis.

Currently total excision with reconstruction of the biliary tree by means of Roux-en-Y hepaticojejunostomy is considered to be the treatment of choice although type III cysts have been shown to respond adequately when managed with endoscopic sphincterotomy.

(Ref.Todani T, Watanabe Y, Narusue M, et al. Congenital bile duct cyst: Classification, operative procedures, review of 37 cases including cancer arising from choledochal cyst. Am J Surg. 1977;134(2):139‒169. and O'Neill JA. Choledochal Cyst. CurrProbl Surg. 1992;29(6):363‒410.)

BILATERAL THALAMIC GLIOMA

2021-05-16T05:15:00.007-07:00

A 9 year old female patient presented with complaint of gradually progressive asymmetrical weakness of all four limbs and difficulty in walking since 1 month. The patient also had c/o difficulty in speaking and hearing since 1 month.

This was associated with c/o low grade fever since last 10 days and c/o dry cough since last 3 days.

The birth history was unremarkable.

The past history, family history and personal history were not significant.

The General Examination revealed deviation of angle of mouth to right side and drooling of saliva.

Systemic examination of Central Nervous System revealed hypertonia in bilateral lower limbs.

INVESTIGATIONS: 1) Mildy elevated WBC levels (12,900)

2)CSF Examination : Normal

3) Vitamin B-12 : Normal

MRI Brain with contrast and whole spine screening was conducted for further evaluation

Fig 1(A to D) reveal abnormal signal intensity lesion causing enlargement of bilateral thalami, appearing hypointense on T1W images (green arrows), hyperintense on T2W images (yellow arrows) and FLAIR images (red arrows); extending into mid brain (white arrows). It is causing effacement of 3^rd ventricle(chevron) with mild dilatation of bilateral lateral ventricles.

The lesion involving right thalamus shows few areas of restriced diffusion on DWI (Fig 1E) with corresponding drop on ADC images (Fig 1F).

The lesion shows no focus of blooming on SWI ( Fig 1G) and no abnormal enhancement on post-contrast images (Fig 1H).

Also MRI whole spine screening was unremarkable.

MR Spectroscopy of the lesion revealed raised choline peak, depressed in N- Acetyl Aspartate peak and increased choline/creatine ratio.

DIAGNOSIS: LOW GRADE BILATERAL THALAMIC GLIOMA

IMAGING: Neuroimaging is indispensable in establishing diagnosis in aﬀected individuals. Typically, BTGs appear as diﬀuse thalamic hypodensities on CT scan with no discrete enhancement. On MRI, these lesions show diﬀuse low signal intensity on T1-weighted images and high signal intensity on T2 / ﬂuid attenuated inversion recovery (FLAIR)-weighted images. The tumor is usually hypo-perfused in perfusion images with no enhancement in contrast study.
Bilateral thalamic lesions are uncommon, with limited diﬀerential diagnoses that include other brain tumours (Lymphomas, teratomas, germinomas), toxic and metabolic disorders (Wernicke's encephalopathy, osmotic myelinosis), vascular conditions (infarcts, deep venous thrombosis) and infection (viral encephalitis, Creutzfeldt-Jakob disease)metabolic and toxic causes, infection, vascular lesions, and neoplasm.The diagnosis can be achieved with patient history, imaging characteristics and presence or absence of associated abnormalities outside the thalami.
In general, MR spectroscopy is not routinely performed for the evaluation of brain tumors, but it can be useful when an imaging result is equivocal. MR spectroscopy may aid the differentiation of primary brain tumors from other non-neoplastic conditions (e.g., vascular diseases, infections, and inflammatory diseases) by analyzing the chemical composition in an anatomical area of interest. The presence of decreased N-acetyl aspartate and increased choline levels are suggestive of a neoplasm.

These findings were detected on MR spectroscopy in the present case.

SPOTTER 8 - TEST YOURSELF

2021-05-14T20:30:00.000-07:00

DANDY WALKER MALFORMATION - ANTENATAL ULTRASOUND

2021-05-13T08:09:00.005-07:00

A 31 year old female with 9 months of amenorrhoea came to emergency for antenatal scan. No previous ultrasound scan was available.

PLAY VIDEO:

Dandy-Walker malformation (DWM) is characterized classically by the triad of cystic dilatation of the fourth ventricle, cerebellar vermis hypoplasia, and hydrocephalus.
DWM is commonly associated with an enlarged posterior fossa, high confluence of the dural venous sinuses (torcular herophili), and higher displacement of the cerebellar hemispheres.
DWM has an incidence of 1 in every 35,000 live births.
Hydrocephalus was considered an essential diagnostic element of DWM, but more recent evidence suggests that it is not present at birth in most patients, though it may develop later in life. In 75 % cases, it develops by 3 months of age.
DWM is associated with a high incidence of motor dysfunction and mental retardation (40%). Most of the symptoms and signs of DWM are related to the hydrocephalus complications.
Hypoplasia/aplasia of the cerebellar vermis with marked dilatation of the fourth ventricle causing a “keyhole configuration” .

FIBROUS DYSPLASIA - POLYOSTOTIC FORM

2021-05-13T07:51:00.000-07:00

A 22 YEARS FEMALE PATIENTS CAME WITH COMPLAINTS OF PAIN OVER RIGHT HIP SINCE 7 YEARS AND IT AGGRAVATES ON MOVEMENTS, DIFFICULTY IN WALKING AND SITTING CROSSED LEG….

Fibrous dysplasia (FD) is a congenital disorder arising from sporadic mutation of the α-subunit of the Gs stimulatory protein.
Osseous changes are characterized by the replacement and distortion of normal bone with poorly organized, structurally unsound, fibrous tissue.
Three basic forms of the disease are currently recognized:
the monostotic form (affecting one bone),
the polyostotic form (affecting many bones),
polyostotic form with associated endocrine abnormalities.

The symptoms of fibrous dysplasia depend on the location of the lesion and often its size.
Many lesions are completely asymptomatic.
Limp and intermittent pain.

RADIOLOGICAL FEATURES:
Ground glass or smoky appearance of the radiolucent lesion is classic.
The fibrous lesion often creates widening of the medullary canal, thinning of the cortex, and endosteal scalloping.
Most lesions demonstrate an encapsulated sclerotic border around the geographic lesion, which has been called the rind of sclerosis.
Shepherd crook deformity of femoral neck
Sarcomatous transformation is rare (0.5%).

Mutation timing determines the extent of the disease and clinical manifestations. The stage of embryogenesis during which a mutation occurs, and the locations to where mutated progenitors subsequently migrate, determines if a patient will have a single lesion, polyostotic disease or one of the FD-related syndromes. Mutations that occur at early stages of embryogenesis result in the widespread distribution of the lesions. Mutations that develop at late stages of embryogenesis lead to more focused distribution of the lesions. Patients with McCuneAlbright syndrome (MAS) may have different extra-skeletal abnormalities. Some of these abnormalities may progress to malignancy; part of them become stable throughout life; some abnormalities can regress or disappear

McCune-Albright syndrome (MAS) is a genetic disorder characterized by the association of:
endocrinopathy: precocious puberty
polyostotic fibrous dysplasia: more severe than in sporadic cases
cutaneous pigmentation: coast of Maine 'cafe au lait' spots
Bone changes in MAS are often more severe than in polyostotic FD without extra-skeletal manifestations.
MAS patients regularly experience multiple fractures, and require adequate surgical treatment

Patients with Mazabraud syndrome have FD lesions and myxomas, typically located in the vicinity of the bone lesions.
Mazabraud syndrome is rare.
The syndrome is more common with the polyostotic form of FD

FLUOROSIS

2021-05-13T07:29:00.000-07:00

A 61 YEARS MALE HAILING FROM RAEBARELI DISTRICT OF U.P., CAME WITH COMPLAINTS OF STIFFNESS OF JOINT WITH RESTRICTED JOINT MOVEMENTS, DIFFICULTY IN WALKING, PAIN IN BACK SINCE 2-3 YEARS AND PAIN IN MULTIPLE JOINTS…..

Chronic fluorosis is a systemic disease
High doses of fluoride leads to bioaccumulation in the body, especially hard tissues such as bones and teeth, and primarily causes significant changes.
Metabolic, structural, and functional damage to the nervous system, kidneys, liver, cardiovascular system and reproductive system.
As Fluoride is a cumulative toxin, its accumulation destroys the processes of bone formation and resorption and also affects collagen and non collagen formation causing changes in collagen cross-linking.

Fluorine is a double edge sword. Inadequate intake is associated with “dental caries” whereas excess intake with “dental and skeletal fluorosis”.
Level > 1.5 ppm : dental fluorosis(mottling).
Level 3.0 – 6.0 ppm : skeletal fluorosis.
Level > 10.0 ppm : crippling fluorosis.
Recommended level in drinking water in India: 0.5-0.8 mg/litre(ppm).

Musculoskeletal fluorosis involves all the bones from head to toe.
In the skull, calcifications of petro-clinoid ligaments, diaphragma sella, ligamentum nuchae etc., are observed.
In the calvarium, diploic thickening prominent occiput and frontal ridges are seen.
In adults, diffuse sclerosis of the axial skeleton with enthesopathy, calcification of the paravertebral ligaments and ligamentum flava.
In the cervical spine, the anterior longitudinal ligament may have flowing hyperostosis simulating diffuse idiopathic skeletal hyperostosis (DISH)

In the thoracic cage, the ribs may show diffuse sclerosis with saw tooth like appearance.
In the pelvis, ligamentous calcification is seen in obturator membrane, sacrospinous, sacrotuberous and Para articular ligaments and lumbosacral ligament.
Bony excrescencies simulating exostosis are noted in the iliac crest.
Ischial tuberosities and bony protuberances. The ischial changes show simulating “whiskering” noted in ankylosing spondylitis

The appendicular skeleton shows variable changes depending upon the stage of fluorosis.
Calcification of the interosseous membrane of the forearm is classical.
Sclerotic changes and periosteal proliferation in the bones of the forearm and hand are common and periosteal proliferation may simulate exostoses.
Often, degenerative changes are noted in the knee joints with calcification of Para articular structures and tendons resulting in deformities.

COMPLICATIONS:

DEGENERATIVE ARTHRITIS
DEGENERATIVE SPONDYLOSIS
PATHOLOGICAL FRACTURES
NEUROLOGICAL ABNORMALITIES
SECONDARY HYPERPARATHYROIDISM.

DERMOID CYST

2021-05-13T07:02:00.005-07:00

65 year old male presented to OPD with a large swelling over nape of neck since 10 to 12 years

PLAY VIDEO:

CT SCAN IMAGES:

Dermoid cysts have been classified as true dermoid cysts, epidermoid cysts and teratoid cysts.
they may result from entrapment of ectodermal tissue of the first and second brachial arches during fetal development or may occur due to traumatic implantation of epithelial cells into deeper tissues.
Dermoid may occur anywhere in the body, with 7% presenting as head-and-neck lesions, most commonly lateral to the eyebrow with lateral eyebrow being the most common location and floor of the mouth, the second most common location .

The essential difference between a dermoid cyst and an epidermoid cyst lies in the presence of skin appendages (eg, sebaceous glands, hair follicles) within the wall of the dermoid cyst and the absence of these features in the epidermoid cyst.
Complex dermoid cysts contain mesodermal elements like cartilage, bone, and fat.

On ultrasound: well defined anechoic masses with posterior enhancement ; may show homogenous internal echoes or heterogenous appearance due to presence of fat, osseous or dental elements.

On CT scans, the central cavity is usually filled with a homogeneous, hypoattenuating (0–18 HU) fluid material. It may appear to be filled with “marbles,” due to the coalescence of fat into small nodules within the fluid matrix . This “sack-of-marbles” appearance is virtually pathognomonic for a dermoid cyst in this location .
Alternatively, the cyst may be heterogeneous on CT scans because of the various germinal components. Fluid-fluid levels with supernatant lipid are possible. The rim of these cysts often enhances following administration of contrast material.

Magnetic resonance imaging (MRI) shows fluid signal due to high protein content, and the areas of fat component will show low signal on fat suppressed images.
Dermoid cysts are T1 hyper- to iso-intense, depending on sebaceous lipid content, and are generally T2 hyperintense.
MRI facilitates visualization of the exact location and extent of cystic lesions in the floor of the mouth and is useful for determining their relationship to the surrounding muscles.

CONGENITAL HYPERTROPHIC PYLORIC STENOSIS

2021-05-13T05:59:00.011-07:00

A 22 day old male presented with c/o vomiting after meals since birth (CLICK ON THE IMAGES TO ZOOM)

PLAY VIDEO:

It refers to the idiopathic thickening of gastric pyloric musculature which then results in progressive gastric outlet obstruction.
2-5 cases per 1000 births.
Clinical presentation:
It typically clinically manifests between 6 to 12 weeks of age.
Clinical presentation is typical with non-bilious projectile vomiting.
Symptoms may start as early as 3 weeks of age.

Associations:

Turner syndrome.
Oesophageal atresia.
Tracheo-esophageal fistula
Trisomy 18

ON plain abdominal radiograph:

Abdominal x-ray findings are non-specific but may show a distended stomach with minimal distal intestinal bowel gas

Ultrasound is the modality of choice
The hypertrophied muscle is hypoechoic, and the central mucosa is hyperechoic. ( Target sign of pyloric stenosis)
pyloric muscle thickness, i.e. diameter of a single muscular wall on a transverse image: >3 mm (most accurate)
Length, i.e. longitudinal measurement: >15-17 mm
pyloric transverse diameter: >13 mm

DUODENAL ATRESIA - XRAY

2021-05-13T05:36:00.004-07:00

•The double bubble sign is seen in infants and represents dilatation of the proximal duodenum and stomach. It is seen in both radiographs and ultrasound, and can be identified antenatally.

•Causes include :

•Congenital obstruction

•duodenal web

•duodenal atresia

•duodenal stenosis

•annular pancreas

•Midgut volvulus

•External compression of the duodenum

•The prevalence ~1 in 5,000-10,000 newborns, and there is no sex-associated difference in prevalence.

•Clinical presentation

•Patients present in early life with symptoms of abdominal distension, vomiting and absent bowel movements.

•Associations

•Associated conditions are common and include:

-Down syndrome:~30% of duodenal atresia cases may have Down syndrome while ~3% of Down syndrome cases may have duodenal atresia

-VACTERL association

-annular pancreas

-other intestinal atresias.

HEREDITARY MULTIPLE EXOSTOSIS

2021-05-13T05:11:00.000-07:00

HEREDITARY MULTIPLE EXOSTOSIS

•Develops during childhood.

•Generally asymptomatic but can cause mechanical symptoms due to impingement or lump formation.

•Usually sporadic but can be part of:
ü Hereditary multiple exostoses (Diaphyseal Aclasia)
ü Trevor disease (Dysplasia epiphysealis hemimelica

•Most common location:
ü Lower limb (DISTAL FEMUR > PROXIMAL TIBIA)
ü Upper limb (HUMERUS)

X-RAY FEATURES:

•Sessile or pedunculated.
•Arises from metaphyseal region typically projecting away from epiphysis.
•Associated broadening of the metaphysis from which it arises.

•Cartilage cap can be thin or thick with rings and arc calcification.

CT FEATURES-

•Better demonstration of medullary continuity and cartilage cap.

MRI FEATURES-

•Assessment of malignant transformation

- Cartilage cap thickness (>1.5 cm)

- Neurovascular compromise

LOCALIZED GIGANTISM ( MACRODYSTROPHIA LIPOMATOSA )

2021-05-13T04:48:00.004-07:00

•Localized gigantism refers to focal enlargement of part of the body, and is always pathological.

Broadly localized gigantism can be divided into two forms :

§static: the region is overgrown but proceeds to grow in proportion to the rest of the body

§progressive: the enlarged region grows faster than the rest of the body

A number of conditions can result in localized gigantism, including:

q neurofibromatosis type 1

q Klippel-Trenaunay-Weber syndrome

q lymphangiomatosis

q haemangiomatosis

q macrodystrophia lipomatosa

q proteus syndrome

•Macrodystrophia lipomatosais a rare form of localized gigantism, and many terms have been used interchangeably, with resulting confusion. They include macrodactyly, megalodactyly, digital gigantism, macromelia, partial acromegaly, macrosomia and limited gigantism.

•Macrodystrophia lipomatosa is essentially analogous to static localized gigantism

•This condition typically presents with painless enlargement of the 2nd or 3rd digit of the hand or foot. It is usually unilateral but may involve adjacent digits in the distribution of the median or plantar nerves. Occasionally it involves the entire limb.

CLINICAL FEATURES:

This condition typically presents with painless enlargement of the 2nd or 3rd digit of the hand or foot. It is usually unilateral but may involve adjacent digits in the distribution of the median or plantar nerves. Occasionally it involves the entire limb.

•Recognized associations include:

•syndactyly

•clinodactyly

•polydactyly

PLAIN RADIOGRAPHS:

•Plain films usually suffice and demonstrate splayed, lengthened and broadened phalanges with endosteal and periosteal bone deposition.

•The overlying soft tissues are markedly overgrown, especially in the volar and distal aspects. Within the soft tissues, focal lucent areas representing fat may be seen, which is characteristic.

TREATMENT:

•Although macrodystrophia lipomatosa is considered a progressive form of macrodactyly (i.e. the growth of the affected parts is faster than the rest of the body) growth halts at puberty

SPOTTERS 7 - TEST YOURSELF

2021-05-13T04:38:00.003-07:00

MALLET FINGER

2021-05-13T04:26:00.002-07:00

•Fractures of the Distal Phalanges. Four types of fracture occur: transverse, longitudinal, comminuted, and chip.

•Chip fractures involve the posterior or anterior corners at the phalangeal base. A posterior chip fracture inactivates extension of the distal interphalangeal joint and produces a ﬂexion deformity (mallet or baseball ﬁnger).

COMPLICATIONS:

•Dorsal ulceration ,nail deformities , and maceration of skin

•Swan neck deformity

RADIOLOGY IN DEGENERATIVE DISEASES

2021-04-26T20:30:00.001-07:00

MALIGNANT LIVER LESIONS - PART 2

2021-04-24T20:30:00.006-07:00

GO THROUGH THIS WONDERFUL LECTURE ON MALIGNANT LESIONS OF LIVER, EXPLAINED IN A CONCISE MANNER.

CLICK HERE FOR PART 1

BENIGN LIVER LESIONS - PART 1

2021-04-22T20:30:00.010-07:00

GO THROUGH THIS WONDERFUL LECTURE ON BENIGN LESIONS OF LIVER, EXPLAINED IN A CONCISE MANNER.

CLICK HERE FOR PART 2

PCPNDT ACT - ALL YOU NEED TO KNOW

2021-04-21T20:30:00.000-07:00

Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act is an Act of the Parliament of India enacted to stop female foeticides and arrest the declining sex ratio in India.

BARODA MEDICAL COLLEGE RADIOLOGY

ULTRASOUND IMAGING IN OBSTETRICS AND GYNAECOLOGY

BATCH OF 2018

MARATHON ACHIEVER - DR. BHARTAN KHARADI (ASSOCIATE PROFESSOR)

DR. BHARTAN KHARADI - MARATHON ACHIEVER

DRAWINGS BY DR. SACHIN PATHARE (RESIDENT)

DRAWINGS BY DR. SACHIN PATHARE (RESIDENT)

OUR COVID WORK

NEW MOBILE DIGITAL RADIOGRAPHY SYSTEM - SAMSUNG GM-85

NEW ULTRASOUND MACHINE IN DEPARTMENT - SAMSUNG RS80 EVO

SAMSUNG RS80EVO

ACHONDROPLASIA

GIANT CHOLEDOCHAL CYST - TYPE I

BILATERAL THALAMIC GLIOMA

SPOTTER 8 - TEST YOURSELF

DANDY WALKER MALFORMATION - ANTENATAL ULTRASOUND

FIBROUS DYSPLASIA - POLYOSTOTIC FORM

FLUOROSIS

DERMOID CYST

CONGENITAL HYPERTROPHIC PYLORIC STENOSIS

DUODENAL ATRESIA - XRAY

HEREDITARY MULTIPLE EXOSTOSIS

LOCALIZED GIGANTISM ( MACRODYSTROPHIA LIPOMATOSA )

SPOTTERS 7 - TEST YOURSELF

MALLET FINGER

RADIOLOGY IN DEGENERATIVE DISEASES

MALIGNANT LIVER LESIONS - PART 2

GO THROUGH THIS WONDERFUL LECTURE ON MALIGNANT LESIONS OF LIVER, EXPLAINED IN A CONCISE MANNER.

CLICK HERE FOR PART 1

BENIGN LIVER LESIONS - PART 1

GO THROUGH THIS WONDERFUL LECTURE ON BENIGN LESIONS OF LIVER, EXPLAINED IN A CONCISE MANNER.

CLICK HERE FOR PART 2

PCPNDT ACT - ALL YOU NEED TO KNOW

Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act is an Act of the Parliament of India enacted to stop female foeticides and arrest the declining sex ratio in India.

GO THROUGH THIS PRESENTATION TO KNOW WHAT YOU NEED TO KNOW AS A RADIOLOGIST.