CT appearances of gastric injury due to caustic ingestion and associated findings (a study of 30 cases).

The mortality and morbidity of acute caustic gastric injuries are high. The spectrum of gastric injury due to caustic ingestion varies from hyperemia, erosion, and extensive ulcers to mucosal necrosis. Severe transmural necrosis can be associated with fistulous complications in the acute and subacute phases and stricture formation in the chronic phase. Due to these important clinical implications, timely diagnosis and appropriate management of gastric caustic injury are crucial, and endoscopy plays a pivotal role. However, critically ill patients or those with overt peritonitis and shock cannot undergo endoscopy. Thoraco-abdominal computed tomography (CT) is preferable to endoscopy as it avoids the risk of esophageal perforation and allows the evaluation of the entire gastrointestinal tract, as well as of the surrounding organs. With the advantage of not being invasive, CT scan has a promising role in the early evaluation of caustic injury. It has an increasing role in the emergency setting with good accuracy in identifying patients who are likely to benefit from surgery. In this pictorial essay, we present the CT spectrum of caustic injury of stomach and associated thoraco-abdominal injuries, with clinical follow-up.

Sonography in acute ocular pathology: a kaleidoscopic view.

Ocular emergencies contribute to a large proportion of ocular pathologies. These may even be organ-threatening diseases such as central retinal artery and vein occlusion or globe rupture. Conventional physical examination may not always be feasible in emergency situations but decision-making in time is critical in the interest of patient in few of these conditions. Sonography in this setting plays an important role, allowing real-time, quick and dynamic evaluation. Common acute ocular pathologies such as retinal detachment, lens dislocation and globe rupture can be easily diagnosed by ultrasound. Vascular lesions can be identified using Doppler. This article illustrates the sonographic appearance in traumatic and non-traumatic acute ocular pathologies.

Prediction of preeclampsia in primigravida in late first trimester using serum placental growth factor alone and by combination model.

We investigated a placental growth factor alone and combined clinical (mean arterial pressure, MAP), biophysical (uterine artery pulsability index, PI) and biochemical (placental growth factor, PLGF) model for predicting preeclampsia in late first trimester. The inclusion criteria was primigravida (<40 years) attending their first hospital visit with singleton pregnancy at 11-14 weeks of gestation. Of the enrolled and followed 291 subjects, 35 (12%) later developed PE (5.8%)/GH (6.2%). An equal number of randomised women with normotensive non-proteinuric course were considered as reference group. For preeclampsia, PLGF alone had detection rate of 40% and 51% with 5% and 10% FPR, respectively. On addition of MAP, the AUC improved to 0.937 for PE. Further, addition of mean PI slightly improved AUC to 0.965. This signifies that a model with all three markers had better prediction of preeclampsia rather than PLGF alone. Impact statement In view of high morbidity and mortality due to hypertensive disorders in pregnancy, there has been extensive research for developing markers to detect/screen the condition in early pregnancy. Several such markers have been tested in their individual capacities and in combination during early pregnancy. Most of these studies have originated from high income countries and focussed mainly on the second trimester of pregnancy. We investigated a placental growth factor alone and combined clinical (mean arterial pressure, MAP), biophysical (uterine artery pulsability index, PI) and biochemical (placental growth factor, PLGF) model for predicting preeclampsia in the first trimester in primigravida (<40 years). A nested case control model was used for our study. For preeclampsia, PLGF alone had detection rate of 40% and 51% with 5% and 10% FPR, respectively. On addition of MAP, the AUC improved to 0.937 for PE. Further, addition of mean PI slightly improved AUC to 0.965. The present study has been done in an Indian subcontinent setting (where maternal mortality related to preeclampsia are even higher) where very limited studies are available for the role of either PLGF or in combinations for prediction of preeclampsia. Our research pointed shows better predictability for PE when a combination of markers is used especially in low-risk nulligravida. These are easy, cheap and non-invasive measurements that can be taken in all women at their first routine antenatal visit.

Superior Mesenteric Artery Syndrome in association with Abdominal Tuberculosis: An Eye Opener.

Superior Mesenteric Artery Syndrome (SMAS) is a rare clinical entity presenting as acute or chronic upper gastrointestinal obstruction. It occurs due to compression of third part of duodenum between abdominal aorta and overlying superior mesenteric artery caused by a decrease in angle between the two vessels. Rapid loss of retroperitoneal fat, in conditions leading to severe weight loss is the main factor responsible for this disorder. Superior mesenteric artery syndrome in association with abdominal tuberculosis has not been reported earlier to the best of our knowledge. Therefore, an unknown cause (SMAS) of upper gastrointestinal obstruction in a patient of abdominal tuberculosis is being presented for the first time through this case report. An imaging diagnosis of SMAS was made on contrast enhanced CT abdomen which also confirmed the clinical suspicion of abdominal tuberculosis in the patient. The patient was managed conservatively and recovered without requiring any surgical intervention for the obstructive symptoms.

Splenic Vein Thrombosis as a Rare Complication of Disseminated Tuberculosis - Imaging Diagnosis and Case Report.

BACKGROUND: Venous thromboembolism is a known but rare complication associated with Mycobacterium tuberculosis infection. The reported incidence of venous thromboembolism is 1.5-3.4% of infected patients, and it occurs due to a hypercoagulable state induced by the associated inflammation. CASE REPORT: A young woman with pulmonary tuberculosis was found to have disseminated tuberculosis and a clinically unsuspected partial thrombus in the splenic vein on imaging. Ultrasound demonstrated hepato-splenomegaly with multiple granulomas as well as ascites and a left-sided pleural effusion. An increased calibre of the splenic vein with a hyperechogenicity within it raised the suspicion of a thrombus, which was confirmed on a contrast-enhanced CT examination. CECT of the abdomen also showed a small peripheral splenic infarct, while CECT of the chest revealed bilateral miliary lesions in the lungs along with necrotic mediastinal lymphadenopathy. The final imaging diagnosis was disseminated tuberculosis complicated by splenic vein thrombosis. A timely institution of anti-coagulant and anti-tubercular treatment led to a complete resolution of the splenic vein thrombosis. CONCLUSIONS: Contrast-enhanced CT serves as a useful imaging tool for the detection of venous thrombosis and for the estimation of a complete burden of the disease. This condition should be kept in mind by both clinicians and radiologists and looked for in order to prevent life-threatening complications.

Kaleidoscopic View of Bowel Tuberculosis on Multi- Detector Computed Tomography (CT) Enterography - A Novel Technique Unfolding an Archaic Disease.

Gastrointestinal tuberculosis (GI TB) is an important manifestation of abdominal tuberculosis (TB), an extra-pulmonary form of the disease. GI TB commonly affects the small bowel but is difficult to diagnose due to the challenge of evaluating the entire length of overlapping small bowel loops with traditional diagnostic methods like Barium meal follow through, abdominal computed tomography (CT), and endoscopy. New techniques of CT/MR enteroclysis/enterography are now available which specifically image the small bowel. MDCT enterography (MDCTE) is a non-invasive, simple to perform, modified abdominal CT imaging technique permitting reasonably accurate evaluation of the small bowel lumen, wall, perienteric tissues, and solid organs within the abdomen. As GI TB can cause morphological alterations in and around the small bowel, MDCTE seems to be an attractive modality for patients suspected of abdominal or GI TB. As scarce literature is available on MDCTE on tuberculosis, we present a pictorial review on MDCTE findings in patients with GI tuberculosis proved on FNAC and clinical and/or imaging follow-up.

Chest Sonography in the Diagnosis of Pneumothorax.

BACKGROUND: Few studies have assessed the utility of chest ultrasonography in the diagnosis of pneumothorax in India. METHODS: Chest ultrasonography was undertaken in 126 haemodynamically stable patients, followed by a chest radiograph within 30 minutes. If pneumothorax was not seen on the chest radiograph, a non-contrast computed tomography of the thorax was performed within 3 hours. The time taken to make or exclude a diagnosis of pneumothorax, by ultrasonography, was assessed. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of chest ultrasonography was estimated. RESULTS: For the diagnosis of pneumothorax in any clinical situation, the average time taken on ultrasonography was less than 2 minutes. The sensitivity, specificity, accuracy, PPV and NPV of chest ultrasonography was 89%, 88.5%, 88.9%, 96.7% and 67.6%, respectively. CONCLUSIONS: Chest ultrasonography can be used as a primary imaging modality in the diagnosis of pneumothorax in a vast variety of clinical situations.

Enthesopathy in patients with nail psoriasis - a cross-sectional evaluation of clinical, onychoscopic and ultrasonographic features.

Background Nail involvement in psoriasis is common and may be an indicator not only of disease severity, but also of the presence of psoriatic arthritis. However, the relationship of nail psoriasis with enthesitis remains under-explored. Aims This study was conducted to evaluate the clinical, onychoscopic (nail dermatoscopic) and ultrasonographic features in patients with nail psoriasis. Materials and Methods All nails of twenty adult patients with nail psoriasis were examined clinically and onychoscopically. Patients were evaluated for psoriatic arthritis (Classification Criteria for Psoriatic Arthritis), the severity of cutaneous disease (Psoriasis Area Severity Index) and nail disease (Nail Psoriasis Severity Index). Ultrasonography of the clinically involved digits was performed for evidence of distal interphalangeal joint enthesitis. Results Out of 20 patients, 18 patients had cutaneous psoriasis and 2 had isolated nail involvement. Among the 18 patients with skin psoriasis, 4 had associated psoriatic arthritis. The most commonly observed clinical and onychoscopic features were pitting (31.2% and 42.2%), onycholysis (36% and 36.5%) and subungual hyperkeratosis (30.2% and 30.5%), respectively. Ultrasonographic evidence of distal interphalangeal joint enthesitis was seen in 57% (175/307) of the digits with clinical nail involvement. Enthesitis was more common in patients with psoriatic arthritis (77% vs 50.6%). Nail thickening, crumbling and onychorrhexis (all features of nail matrix involvement) were significantly associated with enthesitis (P < 0.005). Limitation The major limitation was the small sample size and lack of controls. Only the clinically involved digits were evaluated for enthesitis. Conclusion Enthesitis was frequently detected on ultrasonography in patients with nail psoriasis, even in clinically asymptomatic individuals. Nail features of thickening, crumbling and onychorrhexis may predict underlying enthesitis and the potential development of arthritis. A comprehensive evaluation could help identify patients with psoriasis at risk for arthritis, helping improve long-term outcomes.

Ultrasonographic Measurement of Fetal Adrenal Gland Size for the Prediction of Success of Induction of Labor Among Primigravida Beyond 40 Weeks Gestation.

Introduction: As the pregnancy advances beyond term, the risk of perinatal morbidity and mortality increases. Hence to prevent these complications associated with postterm pregnancy, induction of labor is done, as per our institution protocol between 40 and 41 weeks of gestation. Induction has its own drawback, so it is essential to identify the women with high chances of failure of induction of labor, to prevent the morbidities associated with induction failure. Aim: To study the role of ultrasonographic fetal adrenal gland enlargement for the prediction of success of labor induction among primigravida beyond 40 weeks gestation. Material and Methods: Low-risk primigravidas beyond 40 weeks gestation, scheduled for induction of labor, were enrolled for the study. Fetal adrenal gland dimensions were measured by using abdominal probe Philips HD 7XE and general electronics logiq P6 pro or any ultrasound machine equipped with 7.5-10 MHz linear array probe and 3.5-5 MHz curved array probe. Results: The fetal adrenal gland length, width and ratio were statistically significant between the successful versus failed induction groups. The cutoff fetal zone ratio > 0.36 for the prediction of successful induction of labor had 90% sensitivity, 89% specificity, 93% PPV and 75% NPV. Conclusion: Fetal zone enlargement (fetal zone ratio > 0.36) is a strong predictor of successful induction of labor as compared to TVL and Bishop's score. It can be used for screening the women, who are destined for induction failure, so that adverse effects of induction of labor can be avoided.

Prevalence of lumbosacral transitional vertebra in patients with chronic low back pain: a descriptive cross-sectional study.

BACKGROUND: Numerous causes of low back pain have been identified like spondylosis, spondylolysis, spondylolisthesis, facet lesions, discal abnormalities, vertebral instability, degenerative osteoarthritis, etc., These causes of low back pain are seen commonly in >50 years of age. Lumbosacral transitional vertebra (LSTV) is a common congenital anomaly with multitude of intermediate morphologic manifestations between the typical sacral and lumbar vertebra reported by some authors as a cause of low back pain. There are racial differences reported in the literature on the prevalence of LSTV. There is no common consensus in literature about the association between LSTV and low back pain. There is a paucity of literature on the subject in the Indian population, hence the current study was conducted. MATERIAL AND METHODS: 60 cases of low back pain and 60 controls were included in the study. Patients between 18-50 years of age with low back pain of >12 weeks duration who were fulfilling the inclusion criteria were included in the study. The plain radiographs were screened by two observers (one Orthopaedician and one Radiologist) for the presence or absence of lumbosacral transitional vertebra (LSTV) and classification was determined by consensus. The incidence of LSTV was calculated in both the groups (cases and controls) and evaluated for statistical significance. RESULTS: Prevalence of lumbosacral transitional vertebra (LSTV) was found to be 38.33% in cases group as compared to control group (21.66%) and was statistically significant (p value <0.05). Prevalence of lumbarisation was higher in case group (10%) in comparison to control group (5.0%) but not found to be statistically significant. Prevalence of sacralisation was also found to be higher in case group (28.33%) as compared to control group (16.67%). This was not found to be statistically significant. CONCLUSION: The present study showed a higher prevalence of lumbosacral transitional vertebra (LSTV) in case group (38.33%) as compared to control group (21.66%) which was found to be statistically significant. Prevalence of lumbarisation and sacralisation were both found to be higher in the case group in comparison to control group, but the difference was not statistically significant. However, further studies with larger sample would be needed to conclusively determine any association between low back pain and subtypes of LSTV.

Corneal manifestations and treatment among patients with COVID-19-associated rhino-orbito-cerebral mucormycosis.

Purpose: TO report the corneal manifestations in patients with COVID-19-associated rhino-orbito-cerebral mucormycosis (ROCM). Methods: This study was a retrospective, observational, and record-based analysis of patients of ROCM with corneal involvement. Results: A total of 220 patients were diagnosed with ROCM over a period of 3 months. Thirty-two patients had developed corneal manifestations. The mean age at diagnosis was 52.84 ± 12.8 years. The associated risk factors were systemic mucormycosis, uncontrolled diabetes, recent COVID-19 infection, and injudicious use of systemic steroids. Twenty-nine patients were known diabetics, 32 had recent COVID-19 infection, and 13 gave a history of injudicious use of steroids. The right eye (RE) was affected in nine patients, the left eye (LE) in 20 patients, and both eyes in three patients. Nine patients had a round-oval corneal ulcer. One patient each had a perforated corneal ulcer with uveal prolapse, sealed perforated corneal ulcer, spontaneously healed limbal perforation, diffuse corneal haze with hyphemia, panophthalmitis, diffuse corneal stromal abscess, limbal ischemia, anterior uveitis with posterior synechiae, inferior corneal facet, and filamentary keratitis. Three patients each had a corneal melt and inferior conjunctival xerosis with chemosis. Orbital exenteration was performed in six patients. Five patients with corneal ulcers healed. Topical eye drops of amphotericin (0.5 mg/ml) cycloplegic, antiglaucoma medications, and lubricant eye drops were started along with systemic antifungals. Conclusion: Central corneal ulcer was the most common manifestation of mucormycosis. A concentration as low as 0.5 mg/ml of amphotericin eye drops was effective in the treatment.

Assessment of inter and intra-observer variation of Leonetti and Tigani CT bases classification of tibial pilon fractures.

INTRODUCTION: tibial pilon fracture constitutes 5-7% of all tibial fractures. The treatment of choice is an open reduction with anatomical articular reconstruction and stable fixation. A relievable fracture classification is needed for the preoperative planning the surgical management of these fractures. Hence, we assessed the inter- and intra-observer variation of Leonetti and Tigani CT bases classification of tibial pilon fractures. MATERIALS AND METHODS: In this prospective study, 37 patients aged between 18-65 years with an ankle fracture were included. All these patients underwent a CT scan for the ankle fracture, and the CT scan was further evaluated by 5 independent observers (Orthopaedic surgeon). A kappa value was determined for inter and intra-observer variation. RESULTS: Leonetti and Tigani's CT-based classification of the kappa values was 0.657 to 0.751, with a mean value of 0.700. The range of values for the intra-observer variation using Leonetti and Tigani CT-based classification on the kappa values was 0.658 to 0.875 with a mean value of 0.755. The P-value < 0.001 states that there was a significant agreement between the inter-observer and intra-observer classification. CONCLUSION: Leonetti and Tigani Classification have shown substantial inter- and intra-observer agreement, and the "4B" subclass of Leonetti and Tigani CT-based classification showed a predominance in the present study.

Primary dural follicular lymphoma masquerading as meningioma: a case report.

Patient presented with a dural-based mass lesion and was diagnosed as having meningioma on imaging. Post-resection histological examination revealed a low grade follicular lymphoma. The patient received cranial radiotherapy and is recurrence-free at 6-month follow-up. Primary dural follicular lymphoma is an exceedingly rare entity with only as few as six reported cases. Herein, the clinico-radio-pathological appearances and treatment protocol of this entity are discussed.

A case of prenatal diagnosis of meckel-gruber syndrome in one of the dizygotic twin of a naturally conceived pregnancy.

Meckel-Gruber syndrome in one twin of a naturally conceived dizygotic twin pregnancy is largely unknown and has not been reported till date. This report illustrates the sonographic features in a case of 20-week twin pregnancy where one twin had an occipital encephalocele, bilateral enlarged and cystic kidneys, hepatic cyst and oligohydramnios but the other twin was normal. The affected twin succumbed within few days after normal vaginal delivery while the normal twin survived and is healthy.

Disc Degeneration in Lumbar Spine of Asymptomatic Young Adults: A Descriptive Cross-Sectional Study.

Objective: This descriptive cross-sectional observational study aimed to investigate the prevalence of various types of disc degeneration in the lumbar spine of asymptomatic young adults. The disc degeneration of lumbar spine could be due to age-related physiological changes than to pathological changes in asymptomatic people. Due to the ethnic and racial differences in lifestyle, it is proposed that the prevalence of disc degeneration in the normal population in different region of the world would differ. There are scarce data on the Indian population on the same. Methods: Fifty individuals between 15 and 30 years of age, with no history of low back pain undergoing MR imaging for spinal pathology other than the lumbar spine, were included in the study. Various abnormalities (herniation HN, annular fissure AF, nuclear degeneration ND) were recorded and their prevalence was calculated by disc counts (DC) and person count (PC). DC is the number of discs with degeneration and PC is the number of patients with disc degeneration. Results: 56% asymptomatic individuals were found to have either HN or AF or ND at one or more levels. The DC of disc degeneration was 20.8% and it was most commonly observed in L4-L5 intervertebral disc (38%) followed by L5-S1 disc (30%). Thirteen individuals had disc degeneration at single level, 12 at two levels and 3 individuals at all the five lumbar intervertebral disc levels. Conclusion: The current study showed a high prevalence of disc degeneration (either HN, AF or ND) in young asymptomatic individuals. Even if the MRI shows disc degeneration, patients can be asymptomatic and one needs to correlate the symptoms with the MRI. The limitations of the current study are small numbers of patients from a localized geographical area; hence, we recommend a larger multi-centric study as a follow-up.

Comparison between reliability of Schatzker's classification and CT based four quadrant classification for tibial plateau fractures.

Introduction: Conventionally used Schatzker and AO/OTA classification, do not identify posterior column injuries in tibial plateau fractures. CT based Four quadrant classification, has been proposed to identify fractures of tibial plateau and help in surgical planning of treatment. However, to assess its validity, there is scanty literature about its reliability (inter and intra-observer variation) and comparison of its reliability with that of the more popular Schatzker classification in classifying tibial plateau fracture. Material and methods: X-rays and CT scans of 35 patients (18-65 years) of closed tibial plateau fractures were assessed by 5 Orthopaedic surgeons and classified by both Schatzker's and Four Quadrant Classification. A similar observation was recorded after 2 months. All observers were blinded for the demographic and clinical details of the patients. Their responses were noted and interobserver and Intraobserver variation was calculated. Kappa Test of Cohen was used to determine the level of agreement, as per Landis and Koch's criteria. The reliability of four quadrant classification was also compared with that of Schatzker's classification. Results: There was a moderate agreement in interobserver variation in observations for Schatzker's classification (on X-rays) which improved to substantial agreement when the observations were recorded after showing both CT and X-rays. The intraobserver variation had substantial agreement. On the other hand, there was a perfect agreement in both intra- and interobserver variation for Four Quadrant Classification. This difference between the reliability of both classifications was statistically significant (p < 0.001). Conclusions: Four Quadrant classification is a more reliable classification having a better agreement on interobserver and intraobserver variation.

Sonography in male infertility: a useful yet underutilized diagnostic tool.

PURPOSE: To assess the utility of comprehensive sonographic examination including scrotal sonography, Testicular Doppler and Transrectal Ultrasound (TRUS) to evaluate the male reproductive system and differentiate between obstructive (OG) and non-obstructive (NOG) causes of azoospermia. METHODS: 30 infertile men with azoospermia and 30 control subjects with normospermia underwent sonographic evaluation. FNAC/biopsy findings were used for assigning a final diagnosis of obstructive or non-obstructive azoospermia. Qualitative and quantitative imaging parameters were retrospectively compared between the groups using Chi-square/Fisher's exact test and unpaired t-test, respectively. P < 0.05 was considered significant. RESULTS: Ectasia of rete testis/epididymal tubules, altered epididymal echogenicity, dilated terminal vas deferens were significantly more common in OG while inhomogeneous testicular echo-texture and reduced testicular vascularity were more common in NOG (P < 0.05). Testicular volume and epididymal head size were significantly higher in OG than in NOG and controls (18.2 ml/10 mm Vs 8.2 ml/7.2 mm and 13.4 ml/8.8 mm respectively; P < 0.05); while Resistive Index (RI) of intra-testicular vessels was higher in NOG as compared to OG and controls (0.65 vs 0.54 and 0.52 respectively; P < 0.05). On ROC curve analysis, cut-off values of testicular volume (AUC: 0.939; P < 0.001), epididymal head size (AUC: 0.772; P = 0.001) and testicular RI (AUC: 0.761; P = 0.001) to differentiate between the groups were 12.1 ml (sensitivity-94.4%; specificity-83.3%), 9 mm (sensitivity-66.7%; specificity-71%) and 0.62 (sensitivity-62%; specificity-100%) respectively. CONCLUSION: Comprehensive sonographic evaluation can be used to differentiate obstructive from non-obstructive infertility and should be routinely incorporated in the diagnostic workup of infertile men with azoospermia.

Unilateral Absence of Sternocleidomastoid and Ipsilateral Trapezius Presenting as Congenital Torticollis: A Case of a Rare Entity.

The most common cause of congenital torticollis is sternocleidomastoid contracture. Torticollis due to a unilateral absence of sternocleidomastoid is very rare. Association of an ipsilateral absence of sternocleidomastoid and trapezius with cerebellar hypoplasia is even rarer. We describe a combination of these rarities in an 11-year-old patient with congenital torticollis.

High resolution ultrasound in subclinical diabetic neuropathy: A potential screening tool.

INTRODUCTION: Detection of subclinical neuropathy can aid in triage, timely intervention and dedicated care to reduce disease progression and morbidity. High resolution sonography has emerged as a promising technique for evaluation of peripheral nerves. The aim of the present study was to assess the utility of high resolution sonography in screening diabetic patients for subclinical neuropathy. METHODS: A total of 70 adult patients with type 2 diabetes mellitus and 30 controls were enrolled; those with clinical features of neuropathy constituted the diabetic polyneuropathy group and those without symptoms/normal nerve conduction the non-diabetic polyneuropathy group. After institutional ethical committee approval and informed consent, high resolution sonography was performed by two musculoskeletal radiologists. Nerves studied were median (elbow and wrist), ulnar (cubital tunnel and Guyon's canal), common peroneal (fibular head) and posterior tibial nerve (medial malleolus).The size (cross sectional area), shape, echogenicity and morphology of nerve were assessed and compared between the groups. RESULTS: The mean cross sectional area of all nerves was significantly higher both in diabetic polyneuropathy and non-diabetic polyneuropathy group compared to controls (p value < .001). Common peroneal nerve cross sectional area of 4.5 mm2 had the highest sensitivity (93%) and specificity (86%) for detecting nerve changes in the non-diabetic polyneuropathy group. The nerves were more rounded, hypoechoic and had an altered morphology in both study groups. CONCLUSION: Presence of sonographic nerve changes in asymptomatic diabetics depicted that morphological alterations in nerves precede clinical symptoms. High resolution sonography detected nerve changes with a good accuracy, and thus, can be a potential screening tool for detection of subclinical diabetic polyneuropathy.

A kaleidoscopic view of male urethral pathologies on 64-slice multidetector computed tomographic urethrography: A novel technique.

Pathologies of the male urethra are mostly obstructive in nature and require imaging to delineate the lesion type, site, extent and associated abnormality of the urinary bladder. Contrast urethrography (CU) is the gold standard investigation for urethral assessment but has many limitations. Cross-sectional imaging is infrequently used for the evaluation of the urethra but has been gaining importance recently. Multidetector computed tomographic urethrography (MDCTU) has the capability of evaluating the entire length of a male urethra in a single setting and overcomes many technical and patient limitations of CU. Being a novel technique, most radiologists are not familiar with MDCTU and the imaging spectrum of various urethral and bladder pathologies. This pictorial review attempts to present the imaging appearance of the normal male urethra and spectrum of pathological findings, with highlights on its advantages over the CU technique.