Imaging of thoracic tuberculosis: pulmonary and extrapulmonary.

Tuberculosis (TB) remains the leading cause of death from a single infectious agent globally, despite being a potentially curable disease. This disease typically affects the lungs but may involve many extrapulmonary sites, especially in patients with risk factors such as HIV infection. The clinical features of extrapulmonary TB may mimic many different disease entities, particularly at less common thoracic sites such as the heart, chest wall, and breast. Imaging has an important role in the early diagnosis of TB, helping to detect disease, guide appropriate laboratory investigation, demonstrate complications, and monitor disease progress and response to treatment. Imaging supports the clinical objective of achieving effective treatment outcome and complication prevention. This review aims to highlight the imaging spectrum of TB affecting both pulmonary and extrapulmonary sites in the thorax. We also briefly provide key background information about TB, such as epidemiology, pathogenesis, and diagnosis.

Imaging of musculoskeletal tuberculosis.

Tuberculosis (TB) represents a major public health problem worldwide. Any tissue may be infected. Involvement of the musculoskeletal (MSK) system account for 1-3% of all tuberculous infections. MSK TB may manifest as tuberculous spondylitis, arthritis, osteomyelitis, and soft tissue infections. Although TB spondylitis may present with distinctive imaging features compared to pyogenic infections of the spine, the imaging semiology of extra-spinal TB infections is mostly nonspecific and may mimic other lesions. TB infections should therefore always be considered in the differential diagnosis, particularly in immunocompromised patients. The aim of this article is to review the imaging features of spinal and extra-spinal MSK TB. Magnetic resonance imaging is considered the modality of choice to make the diagnosis and to evaluate the extent of the disease.

Imaging of infra-thoracic tuberculosis.

Tuberculosis (TB) is a potentially curable disease that is a leading cause of death globally. While it typically affects the lungs, this disease may involve many extra-pulmonary sites, particularly in patients with risk factors. Extra-pulmonary TB often mimics a variety of different diseases, posing a diagnostic dilemma. Imaging aids in early diagnosis of TB, especially in patients with non-specific or atypical symptoms found at extra-pulmonary infra-thoracic locations. Imaging also helps guide appropriate laboratory investigation, monitor disease progress, and response to treatment. This review aims to highlight the imaging spectrum of TB affecting the infra-thoracic region, that is, gastrointestinal tract, abdominal lymph nodes, peritoneal cavity, intra-abdominal solid organs, and urogenital system.

Imaging of musculoskeletal tuberculosis.

Extra-pulmonary tuberculosis (TB) of the musculoskeletal system usually manifests with non-specific clinical features, mimicking a variety of diseases. Diagnosis and treatment of spinal and extra-spinal musculoskeletal TB are often challenging. Imaging has an important role in detecting this disease, aiding diagnosis, identifying complications, and monitoring disease progression. Radiographs and magnetic resonance imaging are the key imaging modalities utilized. Radiologists should aim to be familiar with the spectrum of imaging features of TB affecting spinal and extra-spinal locations in the musculoskeletal system.

Adaptability and responsiveness: keys to operational measures in a regional hospital radiology department during the current COVID-19 pandemic.

The rapid and mostly uncontrolled spread of the coronavirus disease 2019 pandemic over the past 4 months has overwhelmed many healthcare systems worldwide. In Singapore, while our public healthcare institutions were considered well prepared due to our prior experience with the SARS outbreak, there was an unexpected surge of infected patients over the recent 2 months to deal with. We describe our radiology department's experience in modifying operational practices and implementing strict infection control measures aimed at minimizing disease transmission and mitigating the potential impact of possible staff infection. From the perspective of serving a medium-sized regional hospital and limited by physical and manpower constraints, our radiology department had to adapt quickly and modify our initial responses and practices as the disease scenario changed. We have also enumerated some guidelines for planning future radiology departments.

The Acutely Injured Elbow.

The acutely injured elbow can present as a diagnostic challenge, encompassing a spectrum of conditions that involve the various osseous and soft tissue structures of this complex joint. Imaging plays a vital role in the management of these patients by providing an accurate interpretation of the underlying trauma sustained, which can have important implications on the preservation of joint function and stability. This article examines the mechanisms, patterns, classifications, and imaging findings of acute elbow injuries, providing key concepts for the radiologist in the interpretation of these injuries.

The role of magnetic resonance imaging in the evaluation of scaphoid fractures.

Radiographs are currently accepted as the first-line modality for the investigation of scaphoid fractures. Early use of magnetic resonance imaging (MRI) in patients with radio-occult scaphoid fractures has been shown to be beneficial in the management of such patients. Incorporation of early MRI into the management protocol for scaphoid fracture is recommended.

Computer Vision Syndrome: Darkness Under the Shadow of Light.

Radiologists typically spend long hours staring at the computer monitor. This unavoidable nature of our work can lead to detrimental effects on the eyes. Moreover, there is little awareness among radiologists with regards to such potential harm. Ocular hazards, such as computer vision syndrome, are increasingly becoming more relevant to the radiology community. In this article, we discuss the ocular occupational hazards faced by radiologists and suggestions that may help in minimizing such hazards.

Imaging of Gastrointestinal and Abdominal Emergencies in Binge Drinking.

Excess alcohol consumption is a leading cause of preventable morbidity and mortality globally. The pattern of consumption of alcoholic beverages has changed in our society in the recent past, with binge drinking becoming more and more common, especially among young adults. Abdominal pain following alcohol consumption can be secondary to a wide range of pathologies, the treatment algorithm of which can range from medical supportive treatment to more invasive life-saving procedures such as transarterial embolization and emergency laparotomy. Correct diagnosis, differentiation among these conditions, and implementing the correct management algorithm is heavily reliant on accurate and appropriate imaging. We review the pathophysiology, clinical presentation, imaging features and management options of acute abdominal emergencies secondary to binge drinking, based on a selection of illustrative cases.

Abdominal radiographs in the emergency department: current status and controversies.

This editorial is discussing about the indiscriminate use of abdominal radiographs in the emergency department in general, with focus on value of the erect abdominal radiograph for the diagnosis of mechanical bowel obstruction and paralytic ileus.

Magnetic Resonance Imaging of Cysts, Cystlike Lesions, and Their Mimickers Around the Knee Joint.

While interpreting routine magnetic resonance imaging (MRI) of the knee joint, a radiologist may encounter various cystic lesions such as ganglion, synovial, and meniscal cysts, among others. In some cases, MRI may demonstrate cystlike lesions around the knee due to fluid distention of normal bursa and recesses, the diagnosis of which should not be difficult if a radiologist is familiar with their characteristic location and MRI appearance. In addition, there are cyst mimickers such as hematomas, abscesses, vascular lesions, and neoplasms around knee joint that may pose a diagnostic challenge on routine MRI. Due to their atypical location and variable morphology, contrast administration is helpful as the enhancement pattern aids to differentiate them from cysts and cystlike lesions. This pictorial essay aims to classify cysts, cystlike lesions, and cyst mimickers in and around the knee joint based on their anatomic location and highlight their characteristic MRI features.

Current Techniques and Clinical Applications of Computed Tomography Urography.

From conventional radiograph to magnetic resonance urography, imaging of urinary system has evolved with variety of investigations over the past several decades with each of them having advantages and limitations of their own. In the current era, computed tomography (CT) has emerged as a preferred investigations for evaluation of the urinary tract. There are various techniques involved in performing CT urography (CTU) with triple bolus technique (TB-CTU) currently drawing a special attention because of its low radiation exposure. This article aims to discuss the current techniques, indications, and clinical applications of CTU with illustrations.

Imaging of Ankle Impingement Syndromes.

Ankle impingement syndromes are a commonly encountered clinical entity seen in athletes, secondary to repetitive forceful microtrauma. Symptoms are related to impingement of osseous or soft tissue abnormalities in the ankle joint, in particular the tibiotalar joint, which may result in painful limitation of ankle movements. Imaging modalities, such as radiographs and magnetic resonance imaging, are very useful in diagnosing osseous and soft tissue abnormalities seen in different types of ankle impingement syndromes. This article reviews the classification of ankle impingement syndromes, their etiology, and clinical and radiological findings.

Greening the Radiology Department: Not a Big Mountain to Climb.

An environmental-friendly radiology department should be a requirement of the future era. The aim of this article is to make radiologists aware of their responsibilities for a greener world. We have suggested a number of minor but important changes in various sections of a radiology department that can make the radiology department more environmentally friendly. These small steps require relatively little effort on our part but cumulatively, may have a huge positive impact on our environment.