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Sohail A, Naqvi J, Wilson P. Spontaneous rectus sheath and retroperitoneal haemorrhage secondary to enoxaparin injections. J Surg Case Rep 2023; 2023:rjad482. [PMID: 37621956 PMCID: PMC10447073 DOI: 10.1093/jscr/rjad482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/05/2023] [Indexed: 08/26/2023] Open
Abstract
Bleeding from enoxaparin is a recognized side effect; however, the formation of rectus sheath and retroperitoneal haematomas is a rare and potentially life-threatening complication. Patients may present insidiously and without symptoms; therefore, high clinical suspicion of a bleeding intra-abdominal haematoma should be suspected in patients with a combination of clinical and biochemical evidence of bleeding. Treatment is patient dependent and is either interventional or conservative in approach. Clinicians should be mindful when prescribing high-dose enoxaparin with further caution advised for at-risk patients.
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Affiliation(s)
- Aroon Sohail
- Lancaster Medical School, Lancaster University, Lancaster LA1 4YW, United Kingdom
- Department of General Surgery, Royal Lancaster Infirmary, Lancaster LA1 4RP, United Kingdom
| | - Jawad Naqvi
- Department of Radiology, Royal Lancaster Infirmary, Lancaster LA1 4RP, United Kingdom
| | - Paul Wilson
- Department of General Surgery, Royal Lancaster Infirmary, Lancaster LA1 4RP, United Kingdom
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Abid Sohail Z, Naqvi J, Gray L. Diagnosis and imaging in COVID-19 induced myositis. BJR Case Rep 2023; 9:20220134. [PMID: 37265755 PMCID: PMC10230232 DOI: 10.1259/bjrcr.20220134] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 06/03/2023] Open
Abstract
The case describes how musculoskeletal disease can manifest in coronavirus disease. The most reported symptoms of covid infection are cough, fever and myalgia. Myalgia and myositis are similar conditions in that they both describe muscular pain and fatigue. However, they are distinguishable in that myalgia is usually benign and self-limiting whilst untreated myositis can lead to serious complications often requiring hospital admission. This case report aims to familiarise physicians with atypical presentations of coronavirus disease to prevent delays in diagnosis and treatment. Timely treatment of covid-induced myositis can decrease in-hospital mortality rates and improve patient outcomes.
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Affiliation(s)
| | - Jawad Naqvi
- Royal Lancaster Infirmary, Lancaster, Lancashire, United Kingdom
| | - Leanne Gray
- Royal Lancaster Infirmary, Lancaster, Lancashire, United Kingdom
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Sivagurunathan G, Shirodkar K, Hegde G, Shamshuddin S, Proctor R, Naqvi J, Knowles D, Ali I. Musculoskeletal Computed Tomography: How to Add Value When Reporting Adult Upper Limb Trauma. J Comput Assist Tomogr 2023; 47:264-276. [PMID: 36877776 DOI: 10.1097/rct.0000000000001417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
ABSTRACT There is increasing reliance on computed tomography to evaluate fractures and dislocations following routine evaluation with plain radiography, critical in preoperative planning; computed tomography can provide multiplanar reformats and 3-dimensional volume-rendered imaging, providing a better global assessment for the orthopedic surgeon. The radiologist plays a critical role in appropriately reformatting the raw axial images to illustrate best the findings that will help determine further management. In addition, the radiologist must succinctly report the pertinent findings that will have the most significant bearing on treatment, assisting the surgeon in deciding between nonoperative and operative management. The radiologist should also carefully review imaging to look for ancillary findings in the setting of trauma beyond the bones and joints, including the lungs and rib cage when visualized.In this review article, we will systematically describe key features for fractures of the scapula, proximal humerus, distal humerus, radial head and neck, olecranon, coronoid process through a case-based approach, and distal radius. Although there are numerous detailed classification systems for each of these fractures, we aim to focus on the core descriptors that underpin these classification systems. The goal is to provide the radiologist with a checklist of critical structures they must assess and findings that they should mention in their report, emphasizing those descriptors that influence patient management.
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Bokka S, Shirodkar K, Naqvi J, Baqai N, Hegde G. Calcaneocuboid capsuloligamentous soft-tissue entrapment: a rare cause of acquired equinovarus deformity. Pediatr Radiol 2023; 53:169-174. [PMID: 35829776 DOI: 10.1007/s00247-022-05432-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/19/2022] [Accepted: 06/13/2022] [Indexed: 01/24/2023]
Abstract
Acquired equinovarus deformity is rare, with most cases related to congenital disorders such as clubfoot. We describe a unique case of traumatic capsuloligamentous soft-tissue entrapment within the calcaneocuboid joint in a 13-year-old girl, causing an acquired equinovarus deformity. This required surgical exploration and joint fixation. Assessing soft-tissue entrapment on magnetic resonance imaging can be beneficial as a potential cause of an acquired post-traumatic non-reducible foot deformity in children. We discuss the intricate capsuloligamentous structures that reinforce the calcaneocuboid joint and highlight the importance of interrogating such structures in the context of inversion injuries to the ankle.
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Affiliation(s)
- Sreekar Bokka
- Department of Medicine, Furness General Hospital, University Hospitals of Morecambe Bay NHS Trust, Dalton Lane, Barrow in Furness, LA14 4LF, UK
| | - Kapil Shirodkar
- Department of Radiology, Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Trust, Ashton Road, Lancaster, LA1 4RP, UK
| | - Jawad Naqvi
- Department of Radiology, Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Trust, Ashton Road, Lancaster, LA1 4RP, UK.
| | - Nadeem Baqai
- Department of Trauma and Orthopaedic Surgery, Furness General Hospital, University Hospitals of Morecambe Bay NHS Trust, Dalton Lane, Barrow in Furness, LA14 4LF, UK
| | - Ganesh Hegde
- Department of Radiology, Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Trust, Ashton Road, Lancaster, LA1 4RP, UK
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Sivagurunathan GM, Naqvi J, Shirodkar K. Magnetic Resonance Imaging of the Elbow: A Systematic Approach. Semin Musculoskelet Radiol 2021. [DOI: 10.1055/s-0041-1731566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Naqvi J, Ali SI, Parmar V, Oh C, Beardmore S, Subedi N. Comprehensive Radiological Assessment of Sub-axial Spinal Injury. Nep Med J 2019. [DOI: 10.3126/nmj.v2i1.24351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Radiologists frequently interpret cross-sectional imaging of the spine in the setting of trauma. Mechanical stability of the traumatised spine is the single most important factor which guides further management.
Several classification systems have been developed over the past to assist radiologists to judge the potentially unstable injuries. The radiologists are arguably most familiar with Denis system of classification which is based on injury morphology and mechanism. This system has been criticised for being too simple, not prognostically valuable and lack of consideration of patients' neurological status. AO (Arbeitsgemeinschaft für Osteosynthesefragen) and TLICS (Thoracolumbar Injury Classification and Severity Score ) classification systems are the next major evolutions which highlight the importance of the posterior ligamentous complex (PLC) and neurological status of the patients in predicting the potentially unstable fracture.
The aim of this pictorial review is to familiarise radiologists with newer classification systems to improve their image interpretation skills and promote efficient communication with spinal surgeons. The pictorial examples are intended to illustrate the various injury types and how to classify them according to the aforementioned classification systems.
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Naqvi J, Hosmane S, Lapsia S. Revisiting the potential signs of colorectal cancer on contrast-enhanced computed tomography without bowel preparation. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s00261-015-0505-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Naqvi J, Nagaraju E, Ahmad S. MRI appearances of pure epithelial papillary serous borderline ovarian tumours. Clin Radiol 2014; 70:424-32. [PMID: 25515794 DOI: 10.1016/j.crad.2014.11.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 11/01/2014] [Accepted: 11/05/2014] [Indexed: 10/24/2022]
Abstract
Borderline epithelial ovarian tumours (BOT) represent 15-20% of all non-benign ovarian epithelial neoplasms. Compared to malignant ovarian tumours, they usually present at a younger age and carry a far superior prognosis. Fertility-conserving surgery is an important treatment option for patients with BOT. Ultrasound and CT are both widely available and play roles in the initial investigation and staging of BOT, respectively. However, lack of soft-tissue contrast limits their ability to characterize BOT. MRI can facilitate recognition of pure epithelial serous BOT (SBOT), including the cystic papillary and surface papillary subtypes. An abundance of hyperintense papillary projections with low signal internal branching and ovarian stroma preservation with a hypointense ovarian capsular margin on T2-weighted imaging are features strongly suggestive of SBOT. In this review we will discuss the general morphological features of SBOT, the benefits and drawbacks of ultrasound and CT in the initial work-up, and the principal MRI features enabling recognition of surface papillary and cystic papillary SBOT.
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Affiliation(s)
- J Naqvi
- Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust, Haslingden Road, Blackburn BB2 3HH, UK.
| | - E Nagaraju
- Burnley General Hospital, East Lancashire Hospitals NHS Trust, Casterton Avenue, Burnley BB10 2PQ, UK
| | - S Ahmad
- Burnley General Hospital, East Lancashire Hospitals NHS Trust, Casterton Avenue, Burnley BB10 2PQ, UK
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Shan SKA, Naqvi J. The carpal bones on a lateral plain radiograph of the wrist. Assoc Med J 2014. [DOI: 10.1136/bmj.g2961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Naqvi J, Udani SD. Sites of tendon insertion on a shoulder radiograph. BMJ 2014; 348:g1889. [PMID: 24603956 DOI: 10.1136/bmj.g1889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Jawad Naqvi
- Department of Clinical Radiology, Blackpool, Fylde, and Wyre Teaching Hospitals, Blackpool, UK
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Naqvi J, Yap KH, Ahmad G, Ghosh J. Transcranial Doppler ultrasound: a review of the physical principles and major applications in critical care. Int J Vasc Med 2013; 2013:629378. [PMID: 24455270 PMCID: PMC3876587 DOI: 10.1155/2013/629378] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 11/10/2013] [Indexed: 12/28/2022] Open
Abstract
Transcranial Doppler (TCD) is a noninvasive ultrasound (US) study used to measure cerebral blood flow velocity (CBF-V) in the major intracranial arteries. It involves use of low-frequency (≤2 MHz) US waves to insonate the basal cerebral arteries through relatively thin bone windows. TCD allows dynamic monitoring of CBF-V and vessel pulsatility, with a high temporal resolution. It is relatively inexpensive, repeatable, and portable. However, the performance of TCD is highly operator dependent and can be difficult, with approximately 10-20% of patients having inadequate transtemporal acoustic windows. Current applications of TCD include vasospasm in sickle cell disease, subarachnoid haemorrhage (SAH), and intra- and extracranial arterial stenosis and occlusion. TCD is also used in brain stem death, head injury, raised intracranial pressure (ICP), intraoperative monitoring, cerebral microembolism, and autoregulatory testing.
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Affiliation(s)
- Jawad Naqvi
- University Hospital South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK
| | - Kok Hooi Yap
- Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK
| | - Gulraiz Ahmad
- Royal Oldham Hospital, Rochdale Road, Manchester OL1 2JH, UK
| | - Jonathan Ghosh
- University Hospital South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK
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Affiliation(s)
- Gulraiz Ahmad
- Pennine Acute Hospitals NHS Trust, Royal Oldham Hospital, Manchester OL1 2JH, UK
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Ahmad G, Naqvi J, Bhatti W. Re: Radiology in the undergraduate medical curriculum — Who, how, what, when, and where? Clin Radiol 2013; 68:e516. [DOI: 10.1016/j.crad.2012.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 12/12/2012] [Indexed: 11/29/2022]
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Naqvi J, Laitt R, Leatherbarrow B, Herwadkar A. A case of a spontaneous intraorbital arteriovenous fistula: clinico-radiological findings and treatment by transvenous embolisation via the superior ophthalmic vein. Orbit 2013; 32:124-126. [PMID: 23414482 DOI: 10.3109/01676830.2013.764444] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A 72-year-old male presented with progressive right axial proptosis and red eye. Catheter angiography demonstrated an intraorbital arteriovenous fistula (IAVF) distal to the central retinal artery (CRA). Transvenous embolisation following direct surgical exposure of the superior ophthalmic vein (SOV) resulted in rapid resolution of his symptoms and signs. Transvenous embolisation via the SOV is a safe, effective alternative to transarterial embolisation for treating spontaneous IAVF where transarterial embolisation poses a risk of CRA occlusion.
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Affiliation(s)
- Jawad Naqvi
- University Hospital of South Manchester, Postgraduate Department, Wythenshawe Hospital, Manchester, United Kingdom.
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Naqvi J, Watts G, Rudralingham V, Duff S. An abnormality at the hepatic flexure. BMJ 2012; 345:e7035. [PMID: 23100331 DOI: 10.1136/bmj.e7035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Jawad Naqvi
- University Hospital of South Manchester, Manchester M23 9LT, UK.
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Naqvi J, Navani N, Saeed S, Shastry M, Groves A, Shaw P, Lawrence D, Kolvekar S, Hayward M, Janes S. P222 A retrospective study of disease recurrence post thoracotomy for non-small cell lung cancer. Thorax 2010. [DOI: 10.1136/thx.2010.151068.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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