This review compiles the current literature on the bleeding risks in common musculoskeletal interventional procedures and attempts to provide guidance for practicing radiologists in making decisions ...regarding the periprocedural management of patients on antithrombotic therapy. The practitioner must weigh the risk of bleeding if therapy is continued against the possibility a thromboembolic occurring if anticoagulation therapy is withheld or reversed. Unfortunately, there is little empirical data to guide evidence-based decisions for many musculoskeletal interventions. However, a review of the literature shows that for low-risk procedures, such as arthrograms/arthrocenteses or muscle/tendon sheath injections, bleeding risks are sufficiently small that anticoagulants and antiplatelet therapies need not be withheld. Additionally, relatively higher-risk procedures, such as needle biopsies of bone and soft tissue, may be safely performed without holding antithrombotic therapy, provided pre-procedural INR is within therapeutic range. Thus, while a patient’s particular clinical circumstances should dictate optimal individualized management, anticoagulation alone is not a general contraindication to most interventional musculoskeletal radiology procedures.
Pituitary dysfunction in adults are often associated with tumors of the gland and manifests with mass effects and hypopituitarism. MRI of pituitary region often provides confirmation of the diagnosis ...and assists in planning neurosurgery.
A 69 years old female evaluated for chronic headache was found to have a supra-sellar mass lesion that mimicked a pituitary tumor, with biochemical evidence of hypopituitarism. Cerebral angiogram confirmed the diagnosis of an aneurysm of the intracavernous internal carotid artery. She was successfully treated with coil embolization of the aneurysm and achieved resolution of symptoms and return of biochemistries to normal.
Carotid aneurysm can mimc pituitary tumours clinically and radiologically on MRI scan. This rare possibility should be considered in evaluating supra-sellar masses to avoid catastrophic consequences.
Background The blue-light hazard is a well-documented entity addressing the detrimental health effects of high-energy visible light photons in the range of 305 nm – 450 nm. Radiologists spend long ...hours in front of multiple light-emitting diode (LED)–based diagnostic monitors emitting blue light, predisposing them to potentially higher blue-light dosages than other health professionals.Objectives The authors aimed to quantify the blue light that radiology registrars are exposed to in daily viewing of diagnostic monitors and compared this with international occupational safety standards.Method A limited cross-sectional observational study was conducted. Four radiology registrars at two academic hospitals in Bloemfontein from 01 October 2021 to 30 November 2021 participated. Diagnostic monitor viewing times on a standard workday were determined. Different image modalities obtained from 01 June 2019 to 30 November 2019 were assessed, and blue-light radiance was determined using a spectroscope and image analysis software. Blue-light radiance values were compared with international safety standards.Results Radiology registrars spent on average 380 min in front of a diagnostic display unit daily. Blue-light radiance from diagnostic monitors was elevated in higher-intensity images such as chest radiographs and lower for darker images like MRI brain studies. The total blue-light radiance from diagnostic display units was more than 10 000 times below the recommended threshold value for blue-light exposure.Conclusion Blue-light radiance from diagnostic displays measured well below the recommended values for occupational safety. Hence, blue-light exposure from diagnostic monitors does not significantly add to the occupational health burden of radiologists.Contribution Despite spending long hours in front of diagnostic monitors, radiologists’ exposure to effective blue-light radiance from monitors was far below hazardous values. This suggests that blue-light exposure from diagnostic monitors does not increase the occupational health burden of radiologists.
Background Little is known about the combined impact of increasing ultrasound usage by clinical disciplines outside radiology and technical advances in other specialised radiological modalities on ...the role of ultrasound in tertiary-level radiology departments.Objectives The aim of this study was to evaluate temporal trends in ultrasound utilisation in a tertiary-level radiology department.Method An institutional review board-approved retrospective descriptive study in the radiology department of Tygerberg Hospital (TBH). The nature and number of ultrasound performed in 2013 and 2019 were retrieved from the TBH radiology information system (RIS). These were compared, expressed as a proportion of the overall annual radiology workload and stratified by location (ultrasound suite, interventional suite, mammography suite). Ultrasound suite examinations were analysed by body part and age (0–13 years;>13 years) and interventional suite workload by procedure.Results The overall radiology workload decreased by 8%, reflecting the interplay between decreased plain radiography (–19%) and general fluoroscopy (–0.3%) and increased computed tomography (27%), magnetic resonance (23%) and fluoroscopically guided procedures (22%).There was a 12% increase in ultrasound utilisation. Ultrasound remained the second most common specialised imaging investigation throughout, after computed tomography. Ultrasound suite services were stable (–1%) representing a balance between decreased abdominal (–22%) and arterial (–16%) scans, and increased musculoskeletal (67%), small part (65%) and neonatal brain scans (41%). There were substantial increases in interventional (90%) and mammography suite (199%) services.Conclusion Ultrasound remains a key modality in the tertiary-level radiology department, with an evolving pattern of clinical applications.
Radiological outcomes between anterior and posterior approach in Lenke 5C curves were still controversial. Meta-analysis on published articles to compare fusion segments and radiological outcomes ...between the two surgical approaches was performed.
Electronic database was conducted for searching studies concerning the anterior versus posterior approach in Lenke 5C curves. After quality assessment, data of means, standard deviations, and sample sizes were extracted. RevMan 5.3 was adopted for data analysis.
Seven case-control studies involving 308 Lenke 5C AIS patients were identified in the meta-analysis. No significant differences were noted in correction rate of thoracolumbar/lumbar curve (95 % CI -6.02 to 4.32, P = 0.75) and incidence of proximal junctional kyphosis (95 % CI 0.12 to 7.19, P = 0.94) of final follow-up, in change values of thoracolumbar/lumbar curve (95 % CI -3.28 to 7.19, P = 0.46) and thoracic kyphosis (95 % CI -4.10 to 0.13, P = 0.07). The anterior approach represented a significant shorter fusion segments compared to posterior approach (95 % CI -1.72 to -0.71, P < 0.00001). The posterior approach obtained a larger increasing Cobb angle of lumbar lordosis than the anterior approach (95 % CI -6.06 to -0.61, P = 0.02).
The anterior and posterior approach can obtain comparable coronal correction, change values of thoracic kyphosis, and incidence of proximal junctional kyphosis. The anterior approach saves approximate one more fusion segment, and the posterior approach can obtain a larger increasing Cobb angle of lumbar lordosis, from preoperation to final follow-up.
The article type of this study is meta-analysis and prospective registration is not required.
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