Vibhor Wadhwa

Sciatic nerve tumor and tumor-like lesions—uncommon pathologies

Sciatic nerve mass-like enlargement caused by peripheral nerve sheath tumors or neurocutaneous syndromes such as neurofibromatosis or schwannomatosis has been widely reported. Other causes of enlargement, such as from perineuroma, fibromatosis, neurolymphoma, amyloidosis, endometriosis, intraneural ganglion cyst, Charcot–Marie–Tooth disease, and chronic inflammatory demyelinating polyneuropathy are relatively rare. High-resolution magnetic resonance imaging (MRI) is an excellent non-invasive tool for the evaluation of such lesions. In this article, the authors discuss normal anatomy of the sciatic nerve and MRI findings of the above-mentioned lesions.

MR imaging of skeletal muscle signal alterations: Systematic approach to evaluation

Muscle edema or edema-like signal alterations are commonly encountered findings in musculoskeletal magnetic resonance (MR) imaging. Although such signal alterations are very sensitive for detection of the underlying muscle pathology, these are often non-specific findings. Encompassing knowledge of their typical clinical presentations, characteristic appearances and patterns of muscle signal alterations and following a systematic approach towards their assessment, a reader can effectively narrow down the differential diagnosis. This article outlines the role of conventional imaging and advanced anatomic and functional musculoskeletal MR imaging techniques in the evaluation of various muscle disorders and presents a systematic approach towards their diagnosis and management.

Diffusion tensor imaging of peripheral nerves

Diffusion tensor imaging (DTI) is a powerful MR imaging technique that can be used to probe the microstructural environment of highly anisotropic tissues such as peripheral nerves. DTI has been used predominantly in the central nervous system, and its application in the peripheral nervous system does pose some challenges related to imaging artifacts, the small caliber of peripheral nerves, and low water proton density. However advances in MRI hardware and software have made it possible to use the technique in the peripheral nervous system and to obtain functional data relating to the effect of pathologic processes on peripheral nerves. This article reviews the imaging principles behind DTI and examines the literature regarding its application in assessing peripheral nerves.

Whole‐body MR neurography: Prospective feasibility study in polyneuropathy and Charcot‐Marie‐Tooth disease

To evaluate the feasibility of whole‐body magnetic resonance neurography (WBMRN) in polyneuropathy for technical feasibility, distribution of nerve abnormalities, and differentiation.

UROGENITAL MYIASIS DUE TO CHRYSOMYIA BEZZIANA

Genitourinary myiasis, associated with ulcerating lesions and poor hygiene of the local site, has been infrequently reported. We report a case of 45 year-old urinary incontinent female suffering from carcinoma cervix, who presented with genitourinary myiasis. The larva was identified as of Chrysomyia bezziana Villeneuve (C. bezziana).

In‐patient discharge rates for the irritable bowel syndrome – an analysis of national trends in the United States from 1997 to 2010

Irritable bowel syndrome (IBS) is one of the most common out‐patient diagnoses in primary care and gastroenterology. There are limited data on the rate and costs associated with in‐patient discharges for IBS.

A fatal pulmonary infection by Nocardia brasiliensis

The reported case is of primary pulmonary nocardiosis, caused by Nocardia brasiliensis, in a immunocompromised patient, which ended fatally despite appropriate treatment. The partially acid fast filamentous bacterium was predominant on direct examination of the sputum. It was cultured on blood agar, MacConkey agar and by paraffin baiting technique. The bacterium was resistant to cotrimoxazole, the drug of choice for nocardiosis.

Pearls and pitfalls of imaging metastatic disease from pancreatic adenocarcinoma: a systematic review

Pancreatic adenocarcinoma is a systemic disease due to the presence of metastatic disease at the time of diagnosis and local recurrence as well as distant metastatic disease after treatment in a majority of patients. Recognition of these metastatic sites may help in accurate staging and assessment of therapeutic response. The authors discuss and illustrate imaging findings of metastatic disease from pancreatic adenocarcinoma in different organ systems with emphasis on entities that can mimic metastatic pancreatic cancer.

Spectrum of Suprascapular Nerve Lesions: Normal and Abnormal Neuromuscular Imaging Appearances on 3-T MR Neurography

OBJECTIVE. In this article, we will review the normal anatomy and imaging features of various neuromuscular abnormalities related to suprascapular neuropathy. CONCLUSION. Suprascapular neuropathy can be difficult to distinguish from rotator cuff pathology, plexopathy, and radiculopathy. Electrodiagnostic studies are considered the reference standard for diagnosis; however, high-resolution 3-T MR neurography (MRN) can play an important role. MRN enables direct visualization of the nerve and simultaneous assessment of the cervical spine, brachial plexus, and rotator cuff.

Dynamic evaluation of pisotriquetral instability using 4-dimensional computed tomography.

Abstract The authors described 2 cases of pisotriquetral instability, which were diagnosed in patients presenting with ulnar wrist clicking and pain. The diagnosis was made first using 4-dimensional computed tomography, which helped further interventions and management in both patients.