Osteoid osteoma is a painful benign bone tumour of children and young adults with characteristic clinico-radiological features depending upon the location of the lesion. Intraoperative visualisation of the nidus is difficult and therefore curative surgery is often associated with excessive bone removal, significant perioperative morbidity and potential need of bone grafting procedures. With advancement in cross-sectional imaging and radiofrequency ablation (RFA) technology, CT-guided RFA has emerged as the treatment of choice for the osteoid osteoma. This procedure involves accurate cannulation of the nidus and subsequent thermocoagulation-induced necrosis. Multidisciplinary management approach is the standard of care for patients with osteoid osteoma. Appropriate patient selection, identification of imaging pitfalls, pre-anaesthetic evaluation and a protocol-based interventional approach are the cornerstone for a favourable outcome. Comprehensive patient preparation with proper patient position and insulation is important to prevent complications. Use of spinal needle-guided placement of introducer needle, namely, “rail–road technique” is associated with fewer needle trajectory modifications, reduced radiation dose and patient morbidity and less intervention time. Certain other procedural modifications are employed in special situations, for example, intra-articular osteoid osteoma and osteoid osteoma of the subcutaneous bone in order to reduce complications. Treatment follow-up generally includes radiographic assessment and evaluation of pain score. Dynamic contrast-enhanced MRI has been recently found useful for demonstrating post-RFA healing.

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Tendinosis is an important cause of musculoskeletal pain and disability. Tendinosis is principally a degenerative process, rather than inflammatory as was traditionally believed. Consequently, traditional tendinosis treatments focused solely on decreasing inflammation, i.e. intratendinous corticosteroid injection has often been ineffective. The advancement of ultrasonography as for the guidance of musculoskeletal intervention has facilitated the development of percutaneous procedures focused on the regenerative healing process for the treatment of tendinosis. In this article, our aim is to illustrate the technical aspects of ultrasound-guided percutaneous needle tenotomy for the treatment of tendinosis.

The virus SARS-CoV2 and the disease spectrum caused by it have led to a widespread impact on the medical and economic status of all nations of the world. This led to an expedited mission to introduce a vaccine which could attempt to neutralize the pandemic to some extent. Many vaccines have been introduced with an acceptable safety profile, producing only mild adverse effects of soreness at injection site, malaise, fever, diarrhoea, myalgia and uncommonly allergic/anaphylactic reactions and possibility of getting infected with SARS-CoV2. Some isolated reports have also emerged of serious thromboembolic phenomena and neurological complications such as Guillain-Barré Syndrome (GBS). A similar incident was noticed at our institute, where a 71 year old male recipient of COVID-19 vaccine at an immunization centre, presented to us with features of GBS. We hereby report this case, not establishing a direct link between the two, but to raise awareness regarding the ongoing mass immunization world-wide.

Introduction Computed tomography (CT)-guided vertebral biopsy is always recommended for histopathological and microbiological confirmation in cases of tuberculous spondylodiscitis and for antimycobacterial drug sensitivity testing. Aim To compare the conventional technique and a novel axis-defined tram-track technique of CT-guided vertebral biopsy in suspected tuberculous spondylodiscitis. Materials and Methods Sixty-seven patients of clinico-radiologically suspected tuberculous spondylodiscitis referred for CT-guided vertebral biopsy were categorized into two groups: “Group A” patients (n = 32) underwent biopsy by conventional technique, and “Group B” patients (n = 35) by axis-defined tram-track technique. The time taken for procedure, radiation exposure, and any procedural complications were recorded for both the groups. Results A statistically significant difference in procedure time and mean radiation dose was observed between the two groups: a longer procedural time was required in “Group A” (52.5 ± 3.5 minutes) as compared to “Group B” (37.3 ± 3.6 minutes) (p < 0.0001); and mean radiation dose (CTDIvol) in “Group A” and “Group B” was 8.64 ± 1.06 mGy and 5.73 ± 0.71 mGy, respectively (p < 0.0001). However, the difference in complication rate and tissue yield for successful diagnosis of the biopsies in the two groups was found to be statistically insignificant. Conclusion Axis-defined tram-track technique was found to have a significantly shorter procedural time as well as lower radiation exposure compared to the conventional technique of vertebral biopsy in our study.