Radiology Preparedness in the Ongoing Battle against COVID-19: Experiences from Large to Small Public Hospitals in Singapore.

The coronavirus disease 2019 (COVID-19) pandemic presents an unprecedented challenge to the health care systems of the world. In Singapore, early experiences of the radiology community on managing this pandemic was shaped by lessons learned from the severe acute respiratory syndrome outbreak in 2003. This article surveys the operational responses of radiology departments from six public hospitals in Singapore. © RSNA, 2020.

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.

Validation of screening questionnaires for evaluation of knee osteoarthritis prevalence in the general population of Singapore.

BACKGROUND: The prevalence of symptomatic knee osteoarthritis (KOA) in Singapore is unknown. We aimed to: (i) validate questionnaires to screen for symptomatic KOA; and (ii) estimate the prevalence of symptomatic KOA in Singapore using the validated algorithms. METHODS: Subjects aged ≥50 years were evaluated for symptomatic KOA based on American College of Rheumatology clinical and radiographic criteria in a rheumatology clinic, and completed three sets of adapted screening questionnaires. The better performing screening questionnaire with adequate sensitivity and specificity was adminitered to a nationally representative sample of survey subjects (n = 3364) to estimate the weighted prevalence of symptomatic KOA in Singapore. RESULTS: Out of 146 subjects evaluated in the clinic, 45 had symptomatic KOA. A screening algorithm which consisted of three KOA symptoms or one symptom plus physician-diagnosed KOA produced high specificity (0.95, 95% confidence intervals [CI]: 0.88-0.98) but low sensivity (0.44, 95% CI: 0.30-0.60). Replacing the term 'KOA' with 'physician-diagnosed ageing-related knee problem' improved the sensivity (0.62, 95% CI: 0.47-0.76) without significantly compromising the specificity (0.87, 95% CI: 0.79-0.93). The prevalence of symptomatic KOA weighted to the Singapore population distribution were 4.7% and 11%, using the most conservative and more liberal algorithms, respectively. There was a sharp rise in prevalence after age of 40. The weighted prevalence of KOA was higher in women and among Indian and Malay than Chinese. CONCLUSION: Our study adapted and validated questionnaires to the local context to screen for symptomatic KOA. We estimated the prevalence of symptomatic KOA in Singapore utilizing the better-performing algorithms.

Clinics in diagnostic imaging (150).

Spontaneous spinal epidural haematoma is a rarely encountered cause of back pain. It often leads to cauda equina syndrome, necessitating emergency spinal surgery. We report the case of a 19-year-old Chinese man who presented with pain in the lower back, which started after he had carried some heavy boxes. He denied a history of fall or trauma. Magnetic resonance (MR) imaging showed a hyperintense biconvex-shaped lesion in the posterior epidural space on both T1- and T2-weighted sequences, diagnostic of a spinal epidural haematoma. The patient, who was admitted and managed conservatively, had gradual resolution of his pain. No neurological deficit was detected on discharge or on follow-up. Repeat MR imaging showed total resolution of the lumbar spinal epidural haematoma. The clinical characteristics, MR imaging features, diagnosis and management of spontaneous spinal epidural haematoma are discussed.

Clinics in diagnostic imaging (144). Lateral meniscal ossicle.

A 35-year-old female patient with previous left knee anterior cruciate ligament repair for a skiing injury presented six years later with a traumatic lateral patellar subluxation. Radiographs and magnetic resonance imaging of her left knee joint showed an ossific structure in the region of the lateral meniscus. This was diagnosed as a meniscal ossicle and confirmed during successful arthroscopic excision. The imaging features of meniscal ossicles are reported.