BACKGROUND: Blunt chest trauma (BCT) is a frequent manifestation of traumatic injury, either as isolated thoracic injury or in the setting of polytrauma. OBJECTIVES: Several chest trauma scores (CTSs) exist based on clinical, biochemical and imaging findings to assist in the risk stratification of patients who have sustained blunt chest trauma. These injuries are often not...
BACKGROUND: Hepatocellular carcinoma (HCC) is highly prevalent in sub-Saharan Africa (SSA). LI-RADS® is a standardised system for imaging-based diagnosis and characterisation of HCC. OBJECTIVES: This study assessed knowledge, attitudes and current practices related to LI-RADS in SSA, with a view to identifying barriers to its utilisation and informing targeted educational...
BACKGROUND: Many South African peripheral medical centres lack direct access to CT scans or neurosurgery. The Glasgow Coma Scale (GCS), used with or without other findings, remains widely utilised in traumatic brain injury (TBI) assessments with lack of standardisation between centres. There is limited data from South Africa (SA) correlating GCS scores to CT imaging in TBI...
Conductive hearing loss (CHL) results from impaired mechanical transmission of sound through the external or middle ear and is commonly associated with conditions such as otosclerosis, cholesteatoma, ossicular discontinuity, congenital malformations and trauma. Less frequently, it may arise from vascular or neoplastic lesions. Imaging plays a central role in the evaluation of CHL...
This case report highlights the findings and treatment in a patient with a splenic arteriovenous fistula causing non-cirrhotic portal hypertension (NCPH). Splenic arteriovenous malformations (AVMs) are rare, and their management using percutaneous embolisation is an emerging alternative modality as opposed to open surgical intervention. CONTRIBUTION: Similar cases have been...
Congenital depressed skull fractures (ping-pong fractures) without obstetric trauma are rare. A term male neonate delivered via uncomplicated caesarean section, demonstrated a right parieto-temporal skull depression (5 cm × 5 cm) at birth. Computed tomography revealed a 4 mm parietal depression without intracranial injury. No instrumental delivery or maternal trauma were present...
BACKGROUND: Assessment of spinal trauma entails a full neurological examination and radiological assessment to determine the level of spinal cord injury. OBJECTIVES: This study aimed to determine if further imaging is always required, whether the clinical picture correlates with imaging results and to compare clinical and radiological prediction accuracy. METHOD: This...
The mediastinum is an unusual location for cystic lymphangiomas. An 18-month-old male presented with acute fever, dry intermittent cough and respiratory distress. Chest radiography, ultrasonography, contrast-enhanced CT and MRI suggested a diagnosis of mediastinal cystic lymphangioma with internal haemorrhage. Surgical excision of the lesion and histopathological examination...
Tracheo-oesophageal fistula (TOF) is a significant congenital anomaly characterised by an abnormal communication between the trachea and the oesophagus. Prompt diagnosis and surgical intervention are crucial, but long-term outcomes depend on accurate imaging and postoperative monitoring. The article discusses the embryological basis, clinical presentation and various types of TOF...
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) procedures are vital in managing complications of portal hypertension. The Viatorr stent is the standard for TIPS, but availability constraints often necessitate the use of alternatives such as WallFlex. Comparative data on their outcomes are limited OBJECTIVES: This study aimed to compare 12-month clinical outcomes...
BACKGROUND: Anterior Cruciate Ligament (ACL) reconstruction is a common orthopaedic procedure, the success of which is ultimately affected by the graft healing process. Quantification of graft healing can be performed non-invasively, using signal-intensity (SI) or signal noise quotient (SNQ) on MRI, however, the variable factors affecting graft healing are still being studied...
This case series highlights the importance of multimodal imaging in distinguishing Klippel-Trenaunay syndrome (KTS) from Parkes Weber syndrome (PWS) and guiding management. Both KTS and PWS are rare congenital vascular disorders characterised by the classic triad of cutaneous vascular malformations, venous varicosities and limb overgrowth. The three cases in this report highlight...
EDITORIALThe great divideMaya PatelDepartment of Radiology, School of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaCorrespondenceIn contrast to other African countries, South Africa is classified as an upper-middle-income country in 2024-2025 according to the World Bank data.1 However, there is a stark dichotomy across the...
BACKGROUND: Triple-negative breast cancer (TNBC) is considered an aggressive subtype, defined by the absence of oestrogen, progesterone and HER2 receptors. It typically presents earlier and more aggressively. Limited data exist on its prevalence, age of onset and imaging features in South Africa. OBJECTIVES: This study aimed to assess the prevalence of TNBC at Helen Joseph...
BACKGROUND: Interventional radiology (IR) is rapidly growing as a critical subspeciality, yet in South Africa (SA) IR training remains underdeveloped, with no national data to guide structured training and workforce expansion. OBJECTIVES: This study aimed to assess South African radiology registrars' interest in IR, their exposure, and the existing training environment. METHOD: A...
BACKGROUND: Breast cancer remains a major public health burden in South Africa, with diagnostic delays contributing to poor outcomes. Ultrasound is effective for early detection but is limited by access and operator variability. Integrating artificial intelligence (AI) into point-of-care ultrasound (POCUS) offers a potential solution. OBJECTIVES: To evaluate the diagnostic...
BACKGROUND: Intussusception is a common cause of paediatric bowel obstruction requiring urgent management to prevent ischaemia. Fluoroscopy-guided air enema reduction (FGAR) is the standard non-surgical treatment for uncomplicated cases OBJECTIVES: To identify factors associated with FGAR outcomes in paediatric intussusception METHOD: A retrospective analytical study was...
BACKGROUND: Magnetic resonance fistulography (MRF) is a key non-invasive imaging technique for mapping perianal fistulas before surgery. The instillation of aqueous jelly, like ultrasound gel, enhances the signal-to-noise ratio, improving image quality and MRF accuracy. This low-cost approach improves accessibility, especially in resource-limited settings, while ensuring patient...
BACKGROUND: Ultrasound elastography, with the measurement of the lesional width ratio between elasticity imaging (EI) and B-mode image (BI) (EI/BI), provides a non-invasive method for breast cancer (BC) characterisation. Evidence from a limited number of researchers supporting the efficacy of this ratio in avoiding unnecessary biopsies warrants further exploration OBJECTIVES: To...
Gallstone ileus is a mechanical bowel obstruction caused by a gallstone within the intestinal tract. It occurs secondary to a fistulous communication between the gallbladder and intestine and commonly causes a small bowel obstruction termed gallstone ileus. It rarely causes a large bowel obstruction termed gallstone sigmoid ileus (GSI) or gallstone coleus. CONTRIBUTION: A case of...
Intercostal artery-to-pulmonary artery fistula is an extremely rare variant of systemic artery-to-pulmonary artery fistulas (SA-PAFs). A case of a 38-year-old man presenting with clinically significant haemoptysis secondary to an intercostal artery-to-pulmonary artery fistula in the setting of post-pulmonary tuberculosis (TB) bronchiectasis is described. The fistulae were...
BACKGROUND: Interventional radiology (IR) is a rapidly advancing speciality which uses various imaging modalities to guide diagnostic and therapeutic procedures. Because of its many proven benefits, IR is becoming an integral part of clinical medicine, often taking preference over traditional therapies. While a vast amount of data have been published on IR experiences, there is a...
BACKGROUND: 4-Dimensional computed tomography (4DCT) is a specialised examination used to locate diseased parathyroid glands in a confirmed case of primary hyperparathyroidism OBJECTIVES: To define the role of 4DCT as a first-hand diagnostic tool in locating the abnormal parathyroid gland METHOD: A retrospective cohort study of 44 patients with primary hyperparathyroidism was...
BACKGROUND: Some clinicians and radiologists in South Africa (SA) suspect that aggressive subtypes of breast cancer are becoming more prevalent and that patients are presenting at younger ages OBJECTIVES: This study aimed to analyse the prevalence and trends in female breast cancer presentations at a Breast Unit in Johannesburg, SA, by comparing data from 2012 and 2022 METHOD: A...
BACKGROUND: Evaluation of diffuse interstitial lung disease (ILD) in thoracic imaging is complicated. Radiologists often use a pattern approach to interpretation; however, they are rarely aware of the statistical frequency of disease presentation OBJECTIVES: To evaluate the relative frequency of causes of fibrotic ILD as a function of imaging patterns METHOD: A CT database of 396...