Background: Obstructive Jaundice is a common surgical problem, MultiDetector Computed Tomography in diagnosis of biliary tract obstruction has a vital role as post processing techniques can be utilized to identify variant biliary anatomy to guide preoperative biliary surgery planning, determine level and cause of obstruction, early tumor detection and staging of biliary cancer are the key factors for possible cure by surgical resection, our aim is to evaluate the role of MDCT in diagnosing level and cause of biliary obstruction. Patients and Methods: Sixty nine patients with clinically suspected biliary obstruction were encountered in the study and subjected to clinical assessment including full history taking, clinical examination and imaging assessment by MDCT, our findings were correlated to standard reference examinations including: Operative/ERCP/Biopsy and histopathology findings. Results: Our results showed that the most affected age group was group between 60: <70 years old, males were affected more than females. The most common clinical presentation in our patients was yellowish discoloration of the skin and sclera followed by biliary colic. Right hypochondrial tenderness was the main clinical finding on clinical examination in our study. Our patients were categorized according to the cause of biliary obstruction into seven groups: Malignant stricture group 52.2% (36patients), Calcular group 24.6% (17patients), Iatrogenic group 5.8% (4patients), Porta hepatis lesions group 5.8% (4patients), Benign stricture group 4.3% (3patients), Inflammatory group 4.3% (3patients), Congenital group 1.4% (1patient). Conclusions: MultiDetector computed tomography provides a modality with high diagnostic performance for differentiating benign from malignant lesions and in detecting biliary calculi.

Background: Cases with pure neural leprosy (PNL) are difficult in their diagnosis and usually loss the early management opportunity. Objective: to evaluate Real time PCR and high resolution ultrasonography of peripheral nerves as diagnostic tools in PNL. Methodology The study included 25 suspected PNL and 25 healthy controls. All patients were subjected to ultrasonography cross-sectional area (CSA) measurement. Fine needle aspiration (FNA) was obtained, and followed by Ziehl-Neelsen (ZN) staining, and real time PCR. Results: ZN staining demonstrated M leprae bacilli in only 8 cases while their DNA was detected in 92 % cases (Sensitivity of both were 100%, and 44.4%, respectively). Only the left median and right and left posterior tibial nerves CSA measurements showed good performance in distinguishing patients of PNL. Median nerve cut off=15.5 mm2 , with a sensitivity of 72%), and right and left posterior tibial nerves CSA Cut Off were 12, 11.5 mm2 with sensitivity of 76-84%. Conclusions: ultrasonography of suspected nerves and real time PCR of nerve aspirates are simple accurate tests for diagnosis of PNL.

Background: plantar fasciitis is the most common cause of inferior heel pain. Sonography should be the initial imaging modality for straight forward confirmation of clinically suspected plantar fasciitis. MRI may be reserved for cases where a more diagnosis of plantar fasciitis is not satisfactory to explain the clinical presentation and when complex pathology is suspected. the aim of the study is to assess the role of MRI in assessment of plantar fasciitis. Methods: This study was carried out at Radio diagnosis Department, Zagazig University Hospitals; the study was carried on 18 patients and 18 asymptomatic volunteers were used as a control group. Ultrasonography and MRI were done to all patients. Results: The plantar fascia was thickened in symptomatic feet. The thickness of the plantar fascia in symptomatic feet was (2.9 -8.4 mm; 6.01± 1.4) measured by ultrasound which was significantly thicker than in the control group (1.90 -3.70 mm; 3.09±0.8), P < 0.05. Other sonographic signs used for the diagnosis of plantar fasciitis in the study were compared to MRI findings. The diagnostic accuracy was 83.3 for plantar fascia thickening, 83.3% for intra-fascial abnormal signal, 77.8% for soft tissue edema, and the lowest diagnostic accuracy of ultrasound was in detection of associated calcaneal spur (38.9%). The findings were tabulated and discussed in relation to other literature. Conclusion: sonographic diagnosis of plantar fasciitis is a useful tool with an acceptable diagnostic accuracy comparable to MRI. Sonography should be the initial imaging modality. MRI may be reserved when complex pathology is suspected.

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