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Abstracts Of Papers At the 62nd Research Meeting Of The Medical Research Centre Of Bombay Hospital On Monday, 14th December 1998, 2.30 Pm In The Sp Jain Cafeteria (Convenor Dr. Hl Dhar)
POST-TRAUMATIC KNEE - MR IMAGING
Inder Talwar, Meher Ursekar, Santosh Gupta
The knee is one of the most frequently injured regions in the body constituting a major cause of pain and disability among the athletic and non-athletic population. MRI is the best non-invasive imaging modality in the diagnosis and evaluation of both the intra-articular and extra-articular injuries involving this complex joint.
A retrospective analysis of 50 cases of post-traumatic knee joint was performed. All the knee joints were examined on the 1.5 Tesla GE Signa machine by utilising T1 weighted, T2 weighted, gradient-echo and special cartilage (3D-SPGP) sequences in multiple planes.
Various types and grades of tear involving the medial and lateral menisci, anterior and posterior cruciate ligaments and the collateral ligament-complexes were observed. Also noticed were associated osteocartilagenous injuries, intra and periarticular fluid collections - including lipohaemarthrosis and parameniscal cysts, in some patients. The most common was medial meniscal tear seen in 19 patients, lateral meniscus - 7 patients, ACL tear - 14, PCL tear - 2 and collateralligament injury in 4 patients.
To conclude, MRI is the best non-invasive diagnostic modality for evaluating post-traumatic knee.
PERCUTANEOUS BRUSH CYTOLOGY OF BILIARY STRICTURES
K Pathak, S Punamiya, A Shah, G Muzumdar
In patients with biliary strictures, a tissue diagnosis is essential because of the various treatment options available. Radiological imaging, in spite of its excellent accuracy in predicting the presence and level of obstruction, has its limitations in assessing the aetiology of biliary obstruction. The difficulty in obtaining a biopsy has encouraged the use of cytological techniques to achieve a tissue diagnosis. This study describes the technique of percutaneous brush cytology and analyses its diagnostic value. 20 cytology samples obtained from 19 consecutive patients (14 male and 5 women aged 33-77 years) who were referred for percutaneous biliary drainage were evaluated. All patients had suspicion of malignant biliary obstruction on imaging methods (USG/CT). Percutaneous transhepatic biliary drainage was done by the standard technique. The stricture was crossed by guide wire and brush samples obtained from the stricture using Combocath (Microvasive, Bosten Scientific Corp.). The slides were reviewed independently by two pathologists and the results compared. It was possible to obtain samples from all patients. Specimens were satisfactory/adequate in 20 (100%), benign in 7 (35%), suspicious in 1 (5%) and positive for malignant cells in 11 (55%). No complications related to brush cytology were noted. There was no increase in the mean hospitalisation period as a result of the procedure of brush cytology. The procedure is simple with a good diagnostic yield and should form part of the routine protocol for percutaneous management of biliary obstruction.
UNUSUAL COMPLICATIONS OF PORTAL HYPERTENSION TREATED BY PERCUTANEOUS RADIOLOGICAL INTERVENTIONS
S Punamiya, K Pathak, DN Amarapurkar
Portal hypertension is an ubiquitous condition with diverse manifestations. Therapy for the complications of portal hypertension depends upon the nature and extent of the underlying liver disease and other clinical factors; the appropriate management may vary from pharmacological to endoscopic to radiological to operative methods. The protocol for the treatment of common complications such as variceal bleeding and ascites have been well defined. However, the uncommon problems do not possess any such treatment strategies, due to their tiny numbers. We discuss here six such cases managed by interventional radiological methods with the short term follow up.
THYROID FUNCTIONS IN DIABETIC AND HYPERTENSIVE PATIENTS ASSOCIATED WITH THYROID DISORDERS
DM Sharma, DR Jangid, HL Dhar
This study was conducted to analyze thyroid functions in diabetic and hypertensive patients associated with thyroid disorders.
Detailed clinical history were taken in 206 patients, reporting for thyroid function studies in NMD T3, T4, TSH were measured. Blood sugar was estimated in diabetic patients, while urea, creatinine and cholesterol were measured in hypertensive patients. Average age ranges from 13-80 years. Female patients were 146 and male were 44. In these patients normal thyroid functions were found in 130 patients (T3 - 1.86 ug/ml, T4 - 98.24 ug/ml and TSH - 4.25 mIU/ml) hypothyroid in 18 patients (T3 - 1.21 ug/ml, T4 - 56.59 ug/ml and TSH - 7.63 mIU/ml) and hyperthyroid in 58 patients (T3 3.21 ug/ml, T4 - 159.4 ug/ml TSH - 0.003 mIU/ml). Number of diabetic patients were 8, HT were 13 and DM and HT together were 6 patients. Other associated diseases like asthma, amoebiasis, hepatitis were also seen in few patients. In HT patients average cholesterol was 185.86 mg%, average creatinine - 1.08 mg% and urea is 26.48 mg%. In diabetic patients average sugar level FBS - 150 mg/100 ml and PPBS - 240 mg/100 ml.
No significant changes were seen in thyroid functions in diabetic and hypertensive patients as large number of patients should be evaluated for results.
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