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V Cassar-Pullicino

Publications and source records attributed to V Cassar-Pullicino.

4 recordsLinked to original sources
PubMed2005

Follow-up imaging of the urinary tract in spinal injury patients: is a KUB necessary with every ultrasound?

STUDY DESIGN: Prospective study of 100 consecutive patients. OBJECTIVES: To evaluate the diagnostic usefulness of the urinary tract (KUB) radiograph routinely performed as part of spinal injury patient urinary tract screening with ultrasound (US) and the KUB radiograph. SETTING: Orthopaedic and District General Hospital with spinal injuries unit, UK. METHODS: Prospective study of the urinary tract of 100 consecutive routine follow-up spinal injury patients with KUB (kidneys, ureters, bladder) radiograph and US of the urinary tract. The percentage of the visualised area of kidneys and urinary bladder and relevant abnormal findings were recorded. Relevant patient history was recorded. RESULTS: In all, 80 men 20 women were examined (average age 46 years, average time since injury 11 years). A total of 199 kidneys and 99 urinary bladders were examined. On average, less than 50% of the renal area and about 70-75% of the urinary bladder area were visualised. Five patients had renal stones identified on the KUB radiograph, and of these two were seen on US. There were no stones seen on US only. The patient history was not helpful to identify patients with renal stones. Significant further renal abnormalities were identified with US in 14 patients, and with the KUB radiograph in 0 patients. Significant urinary bladder abnormalities were identified with US in 20 patients, and with the KUB radiograph in 0 patients. CONCLUSION: On average, less than 50% of the kidney area is visualised on the KUB due to overlying bowel markings making the KUB radiograph a poor tool to assess the kidneys. The KUB radiograph and US are poor tools to assess urinary tract stones. In the absence of a therapeutic consequence, the KUB radiograph does not seem justified in the routine follow-up of the urinary tract in spinal injury patients.

Adult↗
PubMed2004

[Imaging of bacterial infections of the sacroiliac joint].

Infection of the sacroiliac joint can be pyogenic or granulomatous and is usually unilateral. There are a number of predisposing conditions including drug abuse and intra articular steroid injection, but in 44% of cases, no definite predisposing factors can be identified. Considerable delay between presentation and diagnosis is recognized. The clinical picture may be non-specific and variable, and clinical suspicion may be low due to the relatively low incidence of the condition. This is compounded by difficulties in clinical examination of the SUs. The diagnosis is based on a history suggestive of infection, clinical or radiographic localization to the SUs, and a positive blood culture or joint aspirate. The pathology of pyogenic sacroiliitis is reviewed with respect to the anatomy of the SU, and the differential diagnoses considered. The imaging findings, and relative merits of all the modalities are discussed with particular consideration given to changes over the course of the disease. Imaging strategies are evaluated and proposed. As the commonest presenting symptom is low back pain, consideration should be given to the addition of a STIR sequence covering the SUs on all routine lumbar spine MR examinations. MR imaging is the most sensitive and specific imaging modality, while CT-guided arthrocentesis improves diagnostic confidence. Tc99MDP blood pool imaging mirrors the clinical features of resolution, and scintigraphy may be the best method to monitor response to treatment. Targeted antibiotic therapy usually leads to a full recovery. A high incidence of clinical suspicion, with MR imaging at an early stage are the essential prerequisites to an accurate diagnosis of bacterial sacroiliitis.

Arthritis, Infectious↗
PubMed1989

Acquired coronal cleft vertebra.

Five patients with acquired coronal clefts in lower lumbar vertebral bodies are presented. The appearances on plain radiographs, skeletal scintigraphy, discography, computed tomography and magnetic resonance imaging (MRI) are described. The aetiological factors are discussed with particular emphasis on the role of the intervertebral disc and the discovertebral junction in the pathomechanics of vertebral body injury. Magnetic resonance imaging was helpful in the radiological assessment and provided information from which an explanation of the clefts could be proposed.

Adult↗