A review of imaging protocols for suspected skeletal dysplasia and a proposal for standardisation.

Expert radiology opinions are often requested to aid diagnosis of skeletal dysplasias or dysostoses, but due to variability in the imaging protocols used at different centres the views presented may be considered inadequate or incomplete resulting in diagnostic delays and increased patient and family anxiety. We propose the introduction of a standardised protocol that may be adapted in certain specific situations.

Urethral injuries after pelvic trauma: evaluation with urethrography.

Urethral injury is a common complication of pelvic trauma that, if undiagnosed, may lead to significant long-term morbidity. Segments of the urethra that are near the pubic rami and the puboprostatic ligaments are particularly vulnerable. Although computed tomography is commonly used for the initial imaging evaluation of patients with polytrauma, urethral injury is better assessed and classified by using urethrography. Complete urethral imaging is especially important at presentation because the insertion of a transurethral bladder catheter may exacerbate an existing injury (eg, cause a partial urethral tear to become a complete transection). However, even for radiologists who are familiar with standard technique, urethrography after pelvic trauma may be particularly challenging because the patient is immobile or a surgical fixation device or indwelling urethral catheter is present. Various methods may used to overcome these difficulties and ensure that optimal images are obtained so that a correct diagnosis can be made without additional imaging evaluations.

Conjoined twins: Radiological experience.

Imaging plays a key role in the management of conjoined twins. Pre-operative multi-modality studies are vital to assess operability and to aid surgical planning. Technical advances in imaging such as high-resolution isovolumetric magnetic resonance imaging (MRI) techniques and three-dimensional modeling now result in extremely accurate anatomical information. Varied information from a comprehensive radiological work-up enables the surgeons to plan the safest possible operative procedure, helps the anesthetic team before and during surgery, and guides the intensive care team in the post-operative phase. This article will review the radiological techniques used in our institution, highlighting potential pitfalls with the various imaging modalities.