Surfing injuries were most common in young adult men. Most injuries presenting to the ED were minor/moderate injuries and did not require hospital admission. The overall pattern of injuries was similar to those found in studies from other countries where surfing is popular; however, there was a higher-than-expected incidence of shoulder dislocation. The trends identified in this study could be used to inform education focused on prevention of the most common injuries. Increased use of protective headwear should be considered.

The significance of median arcuate ligament-associated coeliac axis compression can be readily delineated by CT angiography but is a source of some controversy in the literature, particularly given the relatively high incidence of this finding in otherwise asymptomatic individuals. This case series, with an emphasis on CT findings, aims to (i) illustrate the anatomy, (ii) elude to the variable outcome and uncertainty of those patients diagnosed, (iii) question the reliability of existing imaging techniques, with the additional use of multiphase electrocardiogram (ECG)-gated CT acquisition, and therefore (iv) augment the description of the currently recognized pathophysiology. We propose the clinical usefulness of ECG-gated vascular angiography, other than that necessary to image the coronary arteries, in vascular compression syndromes such as this.

ABSTRACT. The aim of this study was to determine the prognostic value of coronary multidetector CT angiography (MDCTA) in patients with an intermediate pre-test probability of significant coronary artery disease (CAD). Patients who underwent 64-slice coronary MDCTA and met the selection criteria were identified and assessed for intermediate pre-test probability. Coronary MDCTA scans were preceded by calcium scoring, whereas all MDCTA scans were interrogated for the presence of plaque composition and the distribution and degree of stenosis. Significant stenosis was classified as being .50% of the luminal diameter. All patients were followed up for the occurrence of (i) cardiac death, (ii) non-fatal myocardial infarction, (iii) unstable angina requiring hospital admission and (iv) revascularisation. 138 patients were included (follow-up of 19.9 months); of these, 8 had a cardiac event (all revascularisations) and all had a positive coronary MDCTA. Patients with normal coronary arteries or nonsignificant stenosis suffered no cardiac events during follow-up. There were significant differences between the two groups regarding the presence of significant stenosis (p,0.001), the presence of plaque (p50.011) and a calcium score .10 (p50.003); 36.4% of patients with significant stenosis underwent revascularisation. In conclusion, this is the first UK study to investigate survival data in a population of intermediate-risk patients with no prior history of CAD who were investigated with coronary MDCTA. Coronary MDCTA can confidently rule out significant CAD in the intermediate-risk population and guide risk factor modification in patients with demonstrated coronary atheroma. The aim of this study was to evaluate patients with an intermediate pre-test probability of significant coronary artery disease (CAD) using multidetector CT angiography (MDCTA) and to follow them up for cardiac events. The risk factor profile was determined for all patients. In our institution, patients at high risk of significant CAD are frequently referred directly for invasive catheter angiography (ICA); those at low risk do not require imaging. Intermediate-probability patients, however, who represent a large proportion of patients seen in the outpatient setting, need further testing, and risk is determined by clinical review and risk factor assessment [1,2]. Exercise testing, stress echocardiography and myocardial perfusion with single positron emission CT (SPECT) studies are all well-established non-invasive methods for the investigation of this group. However, the sensitivity and specificity for significant CAD are less than ideal. Meta-analysis of the literature pertaining to these non-invasive methods quotes exercise testing as having a sensitivity and specificity of 68% and 77%, respectively [3], stress echocardiography a sensitivity and specificity of 85% and 77%, respectively, and myocardial perfusion a sensitivity and specificity of 87% and 64%, respectively [4] (the definition of significant CAD varies within these meta-analyses and incl...

This study has demonstrated the potential of (1)H MRS to provide an additional marker of the success of UAE.

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