Extensive Osteochondroma of the Talus Presenting As Syndesmotic Joint Extension and Posterior Inferior Tibiofibular Ligament Rupture: A Reportof a Rare Case and a Review of the Literature.

This case report describes a rare occurrence of talar osteochondroma extending into syndesmosis, causing disruption of the interosseous membrane and the posterior inferior tibiofibular ligament (PITFL). This type of presentation for a talar osteochondroma is the first of its kind reported in the literature based on current knowledge. A detailed preoperative radiological assessment was crucial in planning the surgical approach and preparing for syndesmotic stabilization during the excision. The patient underwent successful and complete excision of the osteochondroma, and the syndesmosis was stabilized using a cortical screw along with anatomical repair of the PITFL. Apart from delayed wound healing, the patient exhibited good functional outcomes in terms of gait and ankle range of motion at the six-month follow-up. This case serves as a valuable reference for similar presentations in the future, emphasizing the importance of thorough preoperative assessment and appropriate treatment planning.

Comparative Evaluation of CBCT and MRI in Temporomandibular Joint (TMJ) Disorders and their Relationship to Periodontal Health.

Cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI) are diagnostic tools frequently employed to evaluate temporomandibular joint (TMJ) disorders, yet their comparative efficacy remains a subject of interest. In this study, we conducted a comparative evaluation of CBCT and MRI in diagnosing TMJ disorders and assessing their association with periodontal health. We recruited a sample of 100 patients presenting with TMJ symptoms and divided them into two groups. Group A underwent CBCT imaging, while Group B received MRI scans. Clinical assessments of periodontal health were performed using established periodontal indices. Diagnostic accuracy, sensitivity, specificity, and interobserver agreement were calculated for each imaging modality. In the current study, CBCT demonstrated superior diagnostic accuracy (85%) compared to MRI (72%) in identifying TMJ disorders. Sensitivity and specificity for CBCT were 87% and 83%, respectively, while for MRI, sensitivity was 68%, and specificity was 76%. Interobserver agreement was substantial for CBCT (κ = 0.75) and moderate for MRI (κ = 0.56). In addition, CBCT revealed a significant correlation between TMJ disorders and periodontal health (P < 0.05), while MRI showed a weaker association (P < 0.1). We concluded from this study and suggest that CBCT is a more accurate imaging modality for diagnosing TMJ disorders compared to MRI. Moreover, CBCT provides valuable insights into the relationship between TMJ disorders and periodontal health, highlighting the importance of comprehensive dental assessments.

Calcific Myonecrosis: Solving the Diagnostic Dilemma.

We report the clinico radiological presentation of an unusual case of an ossified soft tissue mass in the leg in a 74-year-old man. Calcific myonecrosis is a rare soft tissue condition characterized by calcified mass within a compartment. Differential diagnosis of myonecrosis include myositis ossificans and sarcomas with propensity for extra-osseous calcification like extra-skeletal osteosarcoma, Ewing's sarcoma and epithelioid sarcoma. This entity is a late complication to trauma and prolonged high pressure state within the leg compartments. With imaging alone, the differential of soft tissue sarcoma could be ruled out but typical natural history of disease and radiopathological features aided in the diagnosis.

Radiographic features of COVID-19 infection at presentation and significance of chest X-ray: Early experience from a super-specialty hospital in India.

BACKGROUND: Due to the relative early lockdown in India, relative greater availability of reverse transcription polymerase chain reaction (RT-PCR) testing, and mandate to admit all positive corona virus disease 2019 (COVID-19) patients, the protocol in our hospital is to perform a baseline chest X-ray (CXR) at the time of admission and for follow up. There are currently limited publications demonstrating the radiographic findings and the role of CXR of COVID-19 patients at presentation. AIMS: Evaluatethe radiographic findings on CXR in COVID-19 patients at presentation. Recommend a guideline for its judicious use. SETTINGS AND DESIGN: Retroprospective study performed on RT-PCR confirmed COVID-19 patients admitted in our hospital between March 31,2020 to May 25, 2020. The study included symptomatic and asymptomatic patients. CXR was performed for218 patients. MATERIALS AND METHODS: Portable bedside CXR was performed. The CXRs were evaluated by three radiologists to record the findings and grade the disease. All variables were expressed as mean, ranges, counts, and percentages. RESULTS: 157 patients (72%) were symptomatic and 61 (28%) were asymptomatic. 104 CXRs (48%) were abnormal (97 in symptomatic (62%) and fourin asymptomatic (6%)). 74 patients (47%) in the symptomatic group had known comorbidities and of these, 62 (84%) had abnormal CXR. 97 CXRs (93%) had bilateral findings and 87 CXRs (84%) had peripherally predominant abnormalities. The lower zone was the most common area of involvement (73%). Ground glass opacity (GGO) was the most common finding (94%-98 CXRs). Mild disease was seen in 56 (54%). CONCLUSION: CXR can be used to assess symptomatic COVID-19 patients at presentation and to grade the severity of disease. It may be avoided in asymptomatic patients.

Advancements in practical and scientific bioanalytical approaches to metabolism studies in drug development.

Advancement in metabolism profiling approaches and bioanalytical techniques has been revolutionized over the last two decades. Different in vitro and in vivo approaches along with advanced bioanalytical techniques are enabling the accurate qualitative and quantitative analysis of metabolites. This review summarizes various modern in vitro and in vivo approaches for executing metabolism studies with special emphasis on the recent advancement in the field. Advanced bioanalytical techniques, which can be employed in metabolism studies, have been discussed suggesting their particular application based on specific study objectives. This article can efficiently guide the researchers to scientifically plan metabolism studies and their bioanalysis during drug development programs taking advantage of a detailed understanding of instances of failure in the past.

Assessment of a fluorescence-enhanced optical imaging system using the Hotelling observer.

This study represents a first attempt to assess the detection capability of a fluorescence-enhanced optical imaging system as quantified by the Hotelling observer. The imaging system is simulated by the diffusion approximation of the time-dependent radiative transfer equation, which describes near infra-red (NIR) light propagation through clinically relevant tissue volumes. The random structures in the background are introduced using a lumpy-object model as a representation of anatomical structure as well as non-uniform distribution of disease markers. The systematic errors and noise associated with the actual experimental conditions are incorporated into the simulated boundary measurements to acquire imaging data sets. A large number of imaging data sets are considered in order to perform Hotelling observer studies. We find that the signal-to-noise ratio (SNR) of Hotelling observer (i) decreases as the strength of lumpy perturbations in the background increases, (ii) decreases as the target depth increases, and (iii) increases as excitation light leakage decreases, and reaches a maximum for filter optical density values of 5 or higher.

Evaluation of anatomical structure and non-uniform distribution of imaging agent in near-infrared fluorescence-enhanced optical tomography.

To date, the assessment of fluorescence-enhanced optical imaging has not been performed owing to (i) the lack of tools necessary for objective assessment of image quality (OAIQ), and (ii) the difficulty to test an untested diagnostic contrast agent in patient studies. Herein, we focus upon the development of a framework for OAIQ which includes a model to simulate both natural tissue heterogeneity as well as heterogeneous distribution of a molecularly targeted fluorophore. Specifically, we use a novel tomographic algorithm previously developed and validated in our laboratory (Roy and Sevick-Muraca, IEEE Trans. Med. Imaging, 2005). Our results show that image generation is (i) unaffected by normal anatomical heterogeneity manifested in endogenous tissue optical properties of absorption and scattering, and (ii) restricted by heterogeneous distribution of fluorophore in the background as the contrast is decreased.

Imaging of ruptured endocyst in an isolated intramuscular hydatid cyst--the Scroll appearance.

The present article reports a case of a 21 years male that was diagnosed to have isolated intramuscular hydatid cyst of the biceps brachii on Ultrasound and MRI. The 'Scroll appearance' of the ruptured endocyst in this case is likely to be an intervening transient stage in evolution of the disease and also indicates recent rupture of the endocyst.