Sajid Ansari

Pott's Spine: Diagnostic Imaging Modalities and Technology Advancements.

Spinal tuberculosis (TB) or Potts spine is the commonest extrapulmonary manifestation of TB. It spreads through hematogenous route. Clinically, it presents with constitutional symptoms, back pain, tenderness, paraplegia or paraparesis, and kyphotic or scoliotic deformities. Potts spine accounts for 2% of all cases of TB, 15% of extrapulmonary, and 50% of skeletal TB. The paradiscal, central, anterior subligamentous, and neural arch are the common vertebral lesions. Thoracic vertebrae are commonly affected followed by lumbar and cervical vertebrae. Plain radiographs are usually the initial investigation in spinal TB. For a radiolucent lesion to be apparent on a plain radiograph there should be 30% of bone mineral loss. Computed tomographic scanning provides much better bony detail of irregular lytic lesions, sclerosis, disc collapse, and disruption of bone circumference than plain radiograph. Magnetic resonance imaging (MRI) is the best diagnostic modality for Potts spine and is more sensitive than other modalities. MRI frequently demonstrates disc collapse/destruction, cold abscess, vertebral wedging/collapse, marrow edema, and spinal deformities. Ultrasound and computed tomographic guided needle aspiration or biopsy is the technique for early histopathological diagnosis. Recently, the coexistence of human immunodeficiency virus infections and TB has been increased globally. In recent years, diffusion-weighted MRI (DW-MRI) and apparent diffusion coefficient values in combination with MRI are used to some extent in the diagnosis of spinal TB. We have reviewed related literature through internet. The terms searched on Google scholar and PubMed are TB, extrapulmonary TB, skeletal TB, spinal TB, Potts spine, Potts paraplegia, MRI, and computed tomography (CT).

Paraspinal and Presacral Extramedullary Hematopoiesis: A Rare Manifestation of Polycythemia Vera

Extramedullary hematopoiesis is characterized by the presence of hematopoietic tissue outside the bone marrow. Extrathoracic extramedullary hematopoiesis is a rare and usually asymptomatic condition. We report a case of a 38-year-old female with paraspinal and presacral extramedullary hematopoiesis with polycythemia vera. Clinical and laboratory evaluation, along with radiological and histopathological findings are described. The diagnosis of the disease was confirmed by CT-guided biopsy. Review of literature is presented.

Aneurysmal bone cyst of temporal bone.

Aneurysmal bone cysts (ABC) are benign neoplasms frequently occurring in the long tubular bones. It is very rare in temporal bone. We report a case of ABC of the left temporal bone in an 8-year-old Asian boy who presented clinically with swelling over the left temporal region for 5 months. CT and MRI features were suggestive of ABC. Surgical resection was performed and on follow-up the patient was doing well. CT and MRI are the imaging modalities for proper evaluation of ABC, aiding to diagnosis and helpful in treatment planning.

Primary Intrapelvic Hydatid Cyst Presenting with Urinary Retention

Although hydatid disease can affect any part of the body, hydatid cysts located at unusual sites may create diagnostic confusion. The primary involvement of the pelvic cavity is a very rare and patients usually present with pressure symptoms affecting the adjacent organs. Herein, we report a case of pelvic hydatid cyst describing the ultrasonography (USG) and computed tomography (CT) findings of disease.

BRODIE'S ABSCESS MIMICKING AS OF MALIGNANCY: CASE REPORT WITH RADIOLOGICAL FEATURES

Brodies abscess is described by a localized collection of abscess usually found in metaphysic of long bones. On imaging it may mimic other malignant and benign bony lesions which need histopathological correlation. After confirming the diagnosis, it can be successfully treated with surgical debridement and proper antibiotics. We report a case of 15 year old female with chronic infection of tibia mimicking as malignancy for which MRI and histopathology was confirmatory in our diagnosis.

Non-immune hydrops fetalis incidentally found on routine obstetric sonography: A case report

Non-immune hydrops fetalis is an uncommon but serious disorder associated with an overall poor prognosis, characterized by abnormal fluid accumulation in two or more fetal serous compartments, together with generalized soft tissue edema. Sonographic detection of hydrops fetalis is usually straightforward, and detailed prenatal diagnostic investigations allow identification of disorders which may be amenable to treatment and avoidance of inappropriate fetal interventions in cases associated with a poor outcome. We present a case of non-immune hydrops fetalis incidentally detected on routine obstetric sonography in a 32-year-old, third gravida woman. She had past history of hydrops fetalis in her first pregnancy, but the second baby was still alive. She had undergone cesarean section and the baby died after a few minutes. Past history and investigations excluded the immune cause of hydrops fetalis, therefore making it most likely the non-immune type.

Orbital Cysticercosis Presenting as Swelling in the Medial Canthus

The orbital involvement of the cysticercosis is a rare manifestation involving eyelids, extraocular muscles, orbit, conjunctiva, anterior chamber, uvea, retina, vitreous and optic nerve. All the extraocular muscles are involved in myocysticercosis. Ultrasonography and Computed tomography are the imaging modalities for evaluation of orbital cysticercosis. The patients can be treated with systemic steroids and albendazole; however surgical excision is the treatment of choice. Hereby, we report an unusual case of orbital myocysticercosis with involvement of medial rectus muscle and swelling in the region of left medial canthus.

Cranial Computed Tomographic Findings of Neurofibromatosis Type 2

Neurofibromatosis type 2 (NF-2) is a rare inherited autosomal dominant disorder, characterized by multiple neoplasms of the central and peripheral nervous system associated with ocular abnormalities. NF-2 is associated with tumors of Schwann cells and meninges. Intracranial schwannoma most frequently involve the vestibulocochlear nerve (eighth cranial nerve). Bilateral eighth cranial nerve schwannomas are the hallmark of NF-2 and diagnostic of this condition. Intracranial meningiomas are also common in this disorder and are often multiple.We report a case of bilateral vestibulocochlear schwannoma and a solitary meningioma in a 17-year-old female who presented with headache and bilateral hearing impairment for last three months. Based on the clinical and computed tomographic (CT) findings, the diagnosis of NF-2 was made.

Incidental Isolated Fibrolipoma of Filum Terminale in Adult

Fibrolipomas of the filum terminale are embryonic in origin and are seen on MR images as small areas of fatty tissue along the filum terminale. These lipomas may result from faulty retrogressive differentiation. Though the lesions are frequently asymptomatic, fibrolipomas are a known cause of cord tethering and the tight filum syndrome. We present a case of isolated fibrolipoma of the filum terminale in an adult male which was detected incidentally on MRI done for evaluation of disc herniation.

Post-Enucleation Orbital Retinoblastoma: Recurrence with Intracranial Metastasis

Retinoblastoma recurrence following enucleation is relatively rare complication. It usually involves orbit, pineal, parasellar or suprasellar regions. Meticulous follow-up during the first two years after surgery should be done in all patients undergoing enucleation for retinoblastoma. Radiotherapy and intensive systemic chemotherapy may be useful in this disease. W e describe an unusual case of orbital recurrence of retinoblastoma with intracranial metastases in a 3 year old girl child. Retinoblastoma, Enucleation, Orbital recurrence, Intracranial metastasis