Alka Kumar

MR features of tuberculous arachnoiditis.

Although tuberculosis is an uncommon cause of spinal arachnoiditis, it needs to be differentiated from other causes of arachnoiditis because it is a treatable disease. Myelography, which is the imaging modality of choice for the chronic adhesive stage of tuberculous arachnoiditis, usually reveals irregularity of the thecal sac, nodularity and thickening of nerve roots, clumping of roots to each other or to the thecal sac, or CSF block. Recently Gd-diethylenetriamine pentaacetic acid enhanced MRI has been found to be useful for the active phase of tuberculous infection, effectively demonstrating abnormally thickened and enhancing meninges, intra- and extramedullary tuberculous nodules, and spinal cord changes. We present the MRI features in a case of acute tuberculous arachnoiditis.

Posterior fossa surgery: an unusual cause of superficial siderosis.

With the widespread use of magnetic resonance imaging, an increasing number of cases of superficial siderosis are being discovered. However, the cause remains uncertain in almost half the cases. We report a case where previous surgery for a pontine hematoma established a pathway for extravasation of blood into the 4th ventricle, resulting in superficial siderosis that was demonstrated on a follow-up magnetic resonance imaging scan 8 years later. This case presents an unusual iatrogenic cause of superficial siderosis that has not been reported previously.

Pharyngoesophageal (Zenker's) diverticulum mimicking thyroid nodule on ultrasonography: report of two cases.

The pharyngoesophageal, or Zenkers, diverticulum is the most common diverticulum of the esophagus. If large in size, it can project to one side (particularly the left side) and be in close proximity to the thyroid, simulating a variety of thyroid nodules depending on its contents. However, awareness of sonographic fea• tures of this entity and real-time demonstration of movement of the contents (air, water, or debris) to and from the diverticulum help make the correct diagnosis. We report two cases of Zenkers diverticulum diagnosed by ultrasonography.

CT findings of malignant change in recurrent respiratory papillomatosis

Recurrent respiratory papillomatosis is a chronic disease of children and young adults associated with various complications, one of which is malignant change. We report CT findings of malignant change in a case of recurrent respiratory papillomatosis.

Value of CT in diagnosing nonneoplastic osteolysis in Paget disease

We present an unusual case of osteolysis, likely due to a stress fracture, in a pagetic pubic bone simulating sarcomatous transformation.

Biomarkers to enhance accuracy and precision of prediction of short-term and long-term outcome after spontaneous intracerebral haemorrhage: a study protocol for a prospective cohort study

BackgroundSeveral studies reported prognostic value of biomarker in intracerebral hemorrhagic (ICH) but they are either preliminary observation or inadequately powered to analyse independent contribution of biomarkers over and above clinical and neuroimaging data.ObjectiveTo examine whether the biomarker can significantly add to the predictive accuracy of prognosis of ICH.Method/designIn a multi-centric prospective cohort study, 1020 patients with ICH within 72 hours of onset are being recruited. After obtaining written informed consent from patients/proxy, venous blood sample (10 ml) is being collected and analysed for C-reactive protein (CRP) level, S100B, Glial fibrillary acidic protein (GFAP), Troponin, change in leukocyte count and Copeptin levels. The patients are telephonically followed using stroke scales (Barthel Index and modified Rankin Scale) at 3, 6, 12 months and 2 years after the recruitment.DiscussionThis protocol will aim at predicting the short term or long term prognosis with the use of clinical, neuroimaging and biomarkers in order to help clinician to stratify patients for early referral or intervention.

Diagnosis of horseshoe kidney on technetium-99m hepatobiliary scintigraphy.

Horseshoe kidney is a common renal anomaly. The diagnosis is usually suggested by radiographs and confirmed with intravenous pyelography, ultrasonography, or computed tomography. Although scintigraphic studies are not usually used to make the initial diagnosis, this common anomaly (which is usually asymptomatic) might be first observed on radionuclide scans incidentally. This is a report on one such case of horseshoe kidney for which the diagnosis was first suggested on hepatobiliary scintigraphy performed for unrelated reasons

Diagnosis of Diabetic Gastroparesis on Tc-99m Hepatobiliary Scintigraphy

Diabetic gastroparesis is a common problem in diabetics, especially insulin-dependent diabetics. The diagnosis usually is suggested on plain radiographs and confirmed on either upper gastrointestinal barium series or radionuclide gastric emptying studies. The clinical diagnosis is not always easy and some patients may present atypically with right upper quadrant pain simulating acute cholecystitis. In these patients, hepatobiliary scintigraphy may be the initial investigation performed and may first demonstrate unsuspected gastroparesis. Therefore, it is useful for the nuclear medicine physician to be aware of this entity to ensure early diagnosis and prompt treatment. The authors report one such case of diabetic gastroparesis that was diagnosed initially on a Tc-99m hepatobiliary scan.