Liqa A. Rousan

Gyrus rectus herniation (GRH) compressing the anterior visual pathway is a rare cause of visual disturbance in the paediatric population, most often secondary to a neoplastic or dysplastic process; true idiopathic herniation is uncommon. We present two cases of male children with GRH compressing the optic nerve and/or optic chiasm. The first patient is a 12-year-old boy who presented with unilateral visual loss without trauma, managed conservatively with complete resolution of symptoms and radiologically stable findings on six-year follow-up. The second patient is an 11-year-old boy who presented with bilateral visual loss following a road traffic accident; MRI demonstrated incidental right gyrus rectus herniation abutting the optic chiasm in the context of traumatic optic neuropathy. These cases illustrate the fact that GRH can deform the paediatric anterior visual pathway, and may represent either a potentially contributory finding or an incidental anatomical variant, emphasizing the importance of clinical concordance.

Testicular Torsion (TT) is a medical emergency in urology caused by the twisting of the spermatic cord leading to restricted blood flow to the testicle. TT can result in irreversible testicular damage or loss if not promptly diagnosed and surgically treated. Early and accurate diagnosis is therefore essential to preserve testicular viability. While medical image analysis has proved valuable in diagnostics, the automated detection of TT remains a challenge due to subtle image variations and limited datasets. In this study, we present a dataset of 323 ultrasound images collected from three hospitals across Jordan, encompassing both normal and TT cases. We evaluated five classification models, including two traditional machine learning models employing a novel DiscreteWavelet Transform (DWT)-based feature extraction method inspired by EEG signal analysis, and three transfer learning models based on pretrained deep architectures. Among the evaluated models, Support Vector Machine (SVM) with DWT and ResNet50 achieved the best performance, with accuracies of 88% and 87% and F1scores of 82% for both. The results demonstrate that both the wavelet-based SVM model and the deep transfer learning model (ResNet50) achieved comparable and reliable performance for automated TT detection.

Hydronephrosis is a common finding on renal ultrasound, but its physiological causes-such as hydration-induced distention-remain under-recognized in healthy individuals. Misinterpreting such cases as pathological may lead to unnecessary investigations. This study aimed to determine whether rapid oral hydration induces transient hydronephrosis in healthy adults, and to characterize its timing, laterality, and reversibility. Fifty-six healthy volunteers (30 males, 26 females; aged 19–45 years) without chronic illnesses underwent baseline renal and bladder ultrasound, followed by rapid oral hydration (20 ml/Kg within 15–30 min). Ultrasound scans were repeated at 60 and 90 min post-hydration, before and after voiding. Hydronephrosis was graded using the Radiology classification system. Statistical significance was defined as p < 0.005. Fifty-six healthy adults (30 males, 26 females; aged 19–45 years) were enrolled in the study. At 60 min, 46.6% of participants developed hydronephrosis, increasing slightly to 48.2% at 90 min. A significant increase in hydronephrosis grade over time was observed (p = 0.0005), predominantly affecting the right kidney (p < 0.001). Post-void imaging showed partial resolution (p = 0.0003), but moderate hydronephrosis persisted in 12.5% at 90 min. Bladder volume did not significantly correlate with hydronephrosis severity. Although males had larger kidneys and bladder volumes, there was no significant gender difference in hydronephrosis incidence. Rapid hydration can induce transient, non-obstructive hydronephrosis in healthy adults, especially on the right side. Radiologists and clinicians must recognize this physiological variant to avoid misdiagnosis and unnecessary work-up in asymptomatic patients undergoing renal ultrasound. Not applicable.

Study Design: Retrospective study. Objective: To describe the MRI findings of RNRs in patients with low back pain, and observe the imaging findings and the clinical outcome post decompression surgery. Methods: The lumbar spine MRI of 202 patients (122 females) with proven RNRs were retrospectively reviewed. The morphology and the location of the RNRs in relation to the level of stenosis were described. The level(s), grade and cause of lumbar canal stenosis were recorded. The persistence of symptoms and the imaging findings on follow up post decompression surgery were recorded. The imaging findings were correlated among each other and with patients’ demographics. Results: Two distinctive morphological appearance of the RNRs were noted: loop (56.4%), and serpentine-shaped. In the majority of the cases the RNRs were located above the level of stenosis (79.7%). Eighteen patients underwent decompression surgery, only 4 patients remained symptomatic post decompression surgery. The RNRs changed in shape and location after decompression surgery. Age was a strong predictor value in the location of the RNRs. There was no correlation between the shape and location of the RNRs, or with the gender of the patients. Conclusion: RNRs is not an uncommon finding on lumbar spine MRI with lumbar canal stenosis. Its importance remains a controversy. A common language between the radiologists and the clinicians is mandatory to aid in the management planning.

Background: Chest CT scan and chest x-rays show characteristic radiographic findings in patients with COVID-19 pneumonia. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia. The study aims at describing the chest x-ray findings and temporal radiographic changes in COVID-19 patients. Methods: From March 15 to April 20, 2020 patients with positive reverse transcription polymerase chain reaction (RT-PCR) for COVID-19 were retrospectively studied. Patients’ demographics, clinical characteristics, and chest x-ray findings were reported. Radiographic findings were correlated with the course of the illness and patients’ symptoms. Results: A total of 88 patients (50 (56.8%) females and 38 (43.2%) males) were admitted to the hospital with confirmed COVID-19. Their age ranged from 3 to 80 years (35.2 ± 18.2 years). 48/88 (45%) were symptomatic, only 13/88 (45.5%) showed abnormal chest x-ray findings. A total of 190 chest x-rays were obtained for the 88 patients with a total of 59/190 (31%) abnormal chest x-rays. The most common finding on chest x-rays was peripheral ground glass opacities (GGO) affecting the lower lobes. In the course of illness, the GGO progressed into consolidations peaking around 6–11 days (GGO 70%, consolidations 30%). The consolidations regressed into GGO towards the later phase of the illness at 12–17 days (GGO 80%, consolidations 10%). There was increase in the frequency of normal chest x-rays from 9% at days 6–11 up to 33% after 18 days indicating a healing phase. The majority (12/13, 92.3%) of patients with abnormal chest x-rays were symptomatic (P = 0.005). Conclusion: Almost half of patients with COVID-19 have abnormal chest x-ray findings with peripheral GGO affecting the lower lobes being the most common finding. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia.

Background: Chest CT scan and chest x-rays show characteristic radiographic findings in patients with COVID-19 pneumonia. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia. The study aims at describing the chest x-ray findings and temporal radiographic changes in COVID-19 patients.Methods: From March 15 to April 20, 2020 patients with positive reverse transcription polymerase chain reaction (RT-PCR) for COVID-19 were retrospectively studied. Patients’ demographics, clinical characteristics, and chest x-ray findings were reported. Radiographic findings were correlated with the course of the illness and patients’ symptoms.Results: A total of 88 patients (50 (56.8%) females and 38 (43.2%) males) were admitted to the hospital with confirmed COVID-19 pneumonia. Their age ranged from 3-80 years (35.2 ±18.2 years). 48/88 (45%) were symptomatic, only 13/88 (45.5%) showed abnormal chest x-ray findings. A total of 190 chest x-rays were obtained for the 88 patients with a total of 59/190 (31%) abnormal chest x-rays. The most common finding on chest x-rays was peripheral ground glass opacities (GGO) affecting the lower lobes. In the course of illness, the GGO progressed into consolidations peaking around 6-11 days (GGO 70%, consolidations 30%). The consolidations regressed into GGO towards the later phase of the illness at 12-17 days (GGO 80%, consolidations 10%). There was increase in the frequency of normal chest x-rays from 9% at days 6- 11 up to 33% after 18 days indicating a healing phase. The majority (12/13, 92.3%) of patients with abnormal chest x-rays were symptomatic (P=0.005).Conclusion: The chest x-ray findings were similar to those reported on chest CT scan in patients with COVID-19, Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia.

Background: Myxoma is a relatively rare mesenchymal tumor seen mainly in the heart and skin. Renal myxomas in particular are exceptionally rare where only 17 cases were previously reported in the English Language literature. Only 2 of the 17 reported cases were located in the renal sinus/pelvis. Case presentation: This is a case of an 18-year-old male patient who complained of right, colicky flank pain associated with abdominal pain and discomfort. Imaging findings revealed right kidney hydronephrosis with a provisional diagnosis of pelviureteric junction (PUJ) stenosis. On computed tomography, there was a very faint thin walled mass abutting the calyces, camouflaged within the dilated renal pelvis. During surgery, a polypoid mass was found at the pelviureteric junction, causing the obstruction. Histological examination showed a hypocellular, paucivascular myxoid neoplasm, with few spindle cells displaying serpentine nuclei and inconspicuous nucleoli. The tumor cells expressed immunoreactivity for vimentin, but not for S100, CD34, actin, or desmin. This will qualify as the third case of renal pelvis myxoma. Conclusion: Myxomas in the renal pelvis/sinus are extremely rare and can present with hydronephrosis and subtle radiological findings mimicking a PUJ stenosis. Being aware of this entity can save the patient unnecessary nephrectomy with possible preservation of the kidney.