Limited formal guidelines, scarcity of cases, and variable manifestation forms all contribute to the challenges of diagnosing hyperparathyroidism-jaw tumor (HPT-JT) syndrome. This condition characterized by parathyroid tumors, fibro-osseous jaw tumors, and renal and gynecological pathologies results in significant morbidity, restricted functionality, and malignancy risk. Genetic testing is the gold standard investigation to evaluate for CDC73 mutations, that cause HPT-JT syndrome. Genetic testing for CDC73 mutations should be encouraged among family members of affected individuals. Surgery is the mainstay of treatment for many of the encountered pathologic entities.We report a 42-year-old female with a history of infertility and right subtrochanteric femoral fracture secondary to osteoporosis. The patient was suspected to have primary hyperparathyroidism secondary to parathyroid adenomas that were later biochemically and scintigraphically proved with subsequent partial parathyroidectomy.One and a half years following the initial presentation, the patient developed gradual swelling of the lower face with regional osseous involvement in addition to the clinical and radiological picture of recurrent parathyroid adenoma. We present this rare diagnosis of HPT-JT syndrome to promote awareness among physicians regarding this essential differential diagnosis. A low threshold for genetic testing and a high index of suspicion for HPT-JT syndrome must be kept in cases of patients presenting with high parathyroid hormone levels and masses. The screening must extend to all the family members as well. With this approach, the high morbidity, facial disfigurement, and significant malignancy risk can be lowered in the affected individuals improving their life expectancy.

Objective: to evaluate the diagnostic accuracy of FACT in clinically suspected cases of Acute Appendicitis in adolescents and adults, taking surgical findings as gold standard. Methods: A total of 335 patients referred from emergency department with clinical suspicion of acute appendicitis were enrolled at Radiology Department, Services Hospital Lahore, from April, 2016 to October, 2016. FACT was performed using multi-slice CT. The cases underwent surgery and the results were recorded. The results of Focused Abdominal Computed Tomography and surgery were compared taking surgical findings as gold standard. Results: The mean age of patients in our study was 23.01 ± 5.479. We found 278 true-positives, 50 true-negatives, 04 false-negatives results, with sensitivity of 98.6%, a specificity of 94.3%, a PPV of 98.9%, a NPV of 92.6%, and an accuracy of 98%. An alternate diagnosis was made by FACT in 40 patients (11.9%). Conclusion: FACT (focused non-enhanced abdominal computed tomography) is a highly accurate imaging modality for diagnosis of acute appendicitis in adolescents and adults. Keywords: Focused Abdominal CT, Acute Appendicitis, FACT, Diagnostic Acuuracy

Objective: To determine the diagnostic accuracy of multidetector computed tomography in detection of esophageal varices in patients with hrpatic cirrhosis. Study Design: Cross Sectional study. Setting: Department of Diagnostic Radiology, Kot Khawaja Saeed Teaching Hospital, Lahore. Period: January, 2021 to July, 2021. Material & Methods: Two hundred seventy five patients diagnosed with liver cirrhosis were included in our study. Multidetector CT of the abdomen was performed using multislice CT and the findings were recorded. The cases underwent endoscopy within the subsequent 8 weeks. The results of MDCT were compared with endoscopy findings, which were taken as gold standard. Results: We found 190 true-positives, 80 true-negatives, 03 false-negatives, and 02 false-positive results. MDCT demonstrated a sensitivity of 98.4%, a specificity of 97.6%, PPV of 99.0%, NPV of 96.4%, and an accuracy of 98.1%. Extra-esophageal findings on MDCT included other porto-systemic collaterals and hepatocellular carcinoma. Conclusion: MDCT is an effective modality for diagnosis of esophageal varices and can be used as a screening test for varices. CT also permits evaluation of extra-luminal pathology that impacts management.