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The original model showed good performance in the Dutch validation population. The updated models resulted in more accurate ALN metastasis prediction and could be useful preoperative tools in selecting low-risk patients for omission of axillary surgery.

Objective  To determine the value of ultrasonography (US) and colour‐flow duplex ultrasonography (CFD) as routine investigations in the diagnosis of scrotal pathologies. Patients and methods  The imaging techniques were applied to 215 consecutive patients with scrotal complaints. The diagnosis of a urologist (D1, made from the patient's history, physical examination and laboratory results) and that of the radiologist (D2, using US and CFD) were compared with the ‘gold standard’ (D3, the operative findings and course of the disease). The sensitivity and specificity of the diagnostic pathways (D1, D2) were determined statistically and compared with D3. Results  The final diagnoses (D3) were testicular torsion (13 patients), torsion of the appendix testis (5), epididymitis (42), inguinal hernia (7), tumour (11), trauma (9), hydrocele (46), epididymal cyst (37), orchitis (10), varicocele (46) and other diagnoses (8). Using D1, the urologist missed seven diagnoses, of which one was a patient with a testicular torsion combined with an inguinal hernia, and one a patient with a tumour. Using US and CFD (D2), the radiologist missed five diagnoses, including one patient with combined testicular torsion and inguinal hernia. Conclusion  For the diagnosis of scrotal disorders, the basic clinical evaluation usually provides the correct diagnosis. However, US and CFD are useful adjuncts which cause a minimal burden to the patient and that in most cases will lead to the correct diagnosis, especially with important diagnoses like testicular torsion, when US and CFD should be performed immediately. If this does not provide a clear diagnosis, the patient should be explored surgically.

Measurements obtained in 50 spinal CT studies of patients referred for suspected lumbo-sacral nerve root compression, were compared to those of a group of 30 individuals asymptomatic in this respect, who had been referred for abdominal pathology. Transverse ligamentous interfacet and transverse dural dimensions were significantly reduced in the sciatica group, with usually normal interpedicular and sagittal dimensions ruling out idiopathic developmental stenosis. The borderline value for ligamentous interfacet distance (ILD) at L4-5 appeared to be 11 mm.

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