The evaluation of muscle diseases has traditionally integrated clinical with biochemical findings, occasionally resorting to muscle biopsy. This article reviews the role and imaging appearances of muscle diseases at MRI, specifically emphasising the role of WBMRI in global assessment of muscle abnormality, and in particular its role in determining distribution and extent of muscle abnormality.

This paper describes a stroke quality improvement (QI) project in a primary stroke centre in a 431-bed hospital serving a local population of 114 000 people. Approximately 170 acute strokes are treated each year in a seven-bed stroke unit managed by three geriatricians with a subspecialty interest in stroke. 24-hour CT radiology service is available. Endovascular thrombectomy (EVT) is performed by neuro-interventional radiology at one of two comprehensive stroke centres located 90–120 min away.In 2018, as part of a national collaborative QI initiative a new national thrombectomy referral pathway was introduced with an aim that all eligible patients be referred for EVT. This initiative included maximising timely access to CT and thrombolysis. Review of local data highlighted significant deficits in these areas.A local QI team convened and a multidisciplinary approach was employed to map the existing process for CT access and time to thrombolysis decision.We describe how focused timesaving interventions such as; new emergency and radiology department ‘pre-alerts’, dedicated acute stroke pagers, new ‘FAST’ registration by clerical staff, new CT ordering codes and new ‘FAST packs’ (including tissue plasminogen activator, paper National Institute of Health Stroke Scale scoring tools, consent forms and EVT patient selection tools) were created and incorporated into a multidisciplinary detailed clinical stroke care pathway.We describe how we achieved our SMART aims; to reduce our door to CT time and to reduce our door to needle time to the national target of less than 30 min. A third aim was to increase the number of patients referred for EVT from our centre.This project is an accurate description of how a multidisciplinary approach combined with teamwork and effective communication can create sustainable improved patient care and is generalisable to all institutions that require timely referral to external centres for EVT.

No abstract

No abstract

Introduction The acetabular labrum is a critical structure within the hip joint. Abnormality of the acetabular labrum is a significant cause of pain, and it plays an integral role in the development of osteoarthritis. This article reviews the normal anatomy and anatomical variants of the acetabular labrum and describes the technique for performing magnetic resonance arthrography. This article also reviews the diagnostic criteria and classification of tears of the acetabular labrum. Conclusion Magnetic resonance arthrography offers the best imaging of the acetabular labrum. The acetabular labrum has little anatomical variation. Irregularity of the labrum and fluid is associated with labral tear. Magnetic resonance arthrography is specific to the diagnosis of the acetabular labrum.