Gait Disturbance … of Red Herrings, Oranges, and Lemons - A Case of Missed Vitamin C Deficiency and Lessons Learnt.

Vitamin C deficiency resulting in scurvy, is considered to be a rare nutritional disorder in developed countries, thus leading to underdiagnosis with exposure to unnecessary investigations and delay in appropriate treatment. The wide myriad of clinical signs and symptoms with which vitamin C deficiency can present (including haematological, musculoskeletal and vague constitutional symptoms that overlap with other common medical conditions), also contributes to this diagnostic challenge. Despite scurvy being habitually thought to be present in children with neurodevelopmental conditions such as autism spectrum disorder, other important at-risk groups that frequently tend to be forgotten include children with persistent fussy eating behaviour, and children with abnormal vitamin C metabolism.

Congenital tufting enteropathy and chronic arthritis: a clinical and radiological perspective.

Congenital tufting enteropathy is a rare condition which presents in early infancy. It is a condition which should be suspected in infants who present with diarrhoea soon after birth. A rare association with arthritis has been observed with a handful of cases documented in the literature.

Reproducibility and Diagnostic Accuracy of Kellgren-Lawrence Grading for Osteoarthritis Using Radiographs and Dual-Energy X-ray Absorptiometry Images.

Advances in image quality from modern dual-energy X-ray absorptiometry (DXA) scanners now allow near radiograph-like quality images at a low radiation dose. This opens potential new applications for the use of DXA scanners to study other musculoskeletal conditions, such as osteoarthritis, which is often investigated by visual assessment of radiographs. Together, osteoporosis and osteoarthritis are the 2 most common musculoskeletal conditions, both of which primarily affect older people.

An evaluation of the use of oral contrast media in abdominopelvic CT.

Objectives: To evaluate the diagnostic efficacy of different oral contrast media (OCM) for abdominopelvic CT examinations performed for follow-up general oncological indications. The objectives were to establish anatomical image quality criteria for abdominopelvic CT; use these criteria to evaluate and compare image quality using positive OCM, neutral OCM and no OCM; and evaluate possible benefits for the medical imaging department.

Methods: Forty-six adult patients attending a follow-up abdominopelvic CT for general oncological indications and who had a previous abdominopelvic CT with positive OCM (n = 46) were recruited and prospectively placed into either the water (n = 25) or no OCM (n = 21) group.

Retrospective review of image quality of CT in polytrauma patients: comparison of patients scanned using a scoop stretcher and without a scoop stretcher.

Increasingly pre-hospital trauma management involves transfer of patients using a scoop stretcher; a number of computed tomography (CT) compatible scoops have recently appeared on the market. We sought to evaluate any differences in image quality in polytrauma patients scanned in a scoop stretcher. CT studies of 234 consecutive patients presenting between December 2011 and August 2012 at our regional level 1 tertiary trauma centre were retrospectively reviewed.

Rapid imaging protocol in trauma: a whole-body dual-source CT scan.

The purpose of this study is to determine whether a single acquisition whole-body trauma multi-detector CT scan is able to reduce resuscitation time, scan time, and effective radiation dose without compromising diagnostic quality in the setting of polytrauma. Retrospective analysis of 33 trauma patients undergoing single acquisition whole-body CT with injury severity scores of ≥ 16 was compared to 34 patients imaged with a segmented whole-body CT protocol. Time spent in the emergency department, effective radiation dose, image quality, and mortality rates were compared.

Role of imaging in penetrating and blunt traumatic injury to the heart.

Cardiac injury due to blunt or penetrating chest trauma is common and is associated with significant morbidity and mortality. Understanding the mechanisms, types, and complications of cardiac injuries and the roles of various imaging modalities in characterizing them is important for appropriate diagnosis and treatment. These injuries have not been well documented at imaging, but there are now fast and accurate methods for evaluating the heart and associated mediastinal structures.

Low-dose MDCT findings of blunt hepatobiliary trauma.

This pictorial essay shows low-dose multi-detector computed tomography (MDCT) findings of blunt hepatobiliary trauma, and describes the indications and protocol for MDCT. Given the universal usage of MDCT in assessing the liver in blunt abdominal trauma, reduction of patient dose is essential. The new l0se MDCT protocol presented here can achieve up to 50% dose reduction while maintaining diagnostic image quality and thus facilitate dose sensitive patient management.

Dual-energy CT as a potential new diagnostic tool in the management of gout in the acute setting.

Objective: Gout is the most common crystal deposition arthropathy currently diagnosed clinically and with arthrocentesis. Dual-energy CT is a promising new imaging technique offering potential new applications in a number of clinical areas.

Conclusion: The ability of dual-energy CT to diagnose early gout and its use as a problem-solving tool is shown here.