Objectives: The objective of our study is to determine the positive rate for urolithiasis in male and female patients, and evaluate whether there has been any change at our institution in the use and outcome of unenhanced multidetector CT (CT KUB) performed in the emergency department (ER) for patients presenting with suspected acute renal colic. Methods: A retrospective review of all 1357 consecutive cases between August 2007 and August 2009 admitted to the ER and investigated with CT KUB. Results: The positive rate for urolithiasis was 47.5% and the rate of other significant findings was 10%. Female patients had a significantly lower positive rate than male patients (26.8% vs 61.6%, p<0.001). Urological intervention was required in 37% and these patients had a larger average stone size. In young female patients with a significantly sized ureteric calculus (>4 mm), the presence of hydronephrosis vs no hydronephrosis was 83% vs 17%, respectively. Among them, only three patients required ureteroscopy for stone removal. Conclusion: Contrary to other studies there has been no “indication creep” in the use of CT KUB at our institution. However, the young female patient presenting with suspected urolithiasis presents a particular diagnostic problem, and the significant percentage of negative examinations in females implies that an improvement in current practice is needed. The indiscriminate use of CT KUB in all female patients with flank pain should be avoided, and it is suggested that they should be initially evaluated with ultrasound to detect the presence of hydronephrosis.

Objectives To evaluate the hypothesis that ultrasound-guided subacromial steroid injection produces greater reduction in morbidity than unguided injection. Design All patients underwent either ultrasound-guided subacromial injection with 80 mg Depo-Medrone at Bradford Royal Infirmary (group 1) or unguided injection (group 2) by a general practitioner with a specialist interest in musculoskeletal medicine (GPwSI). Patients were clinically and ultrasonically diagnosed with subacromial impingement syndrome. Setting Patients in group 1 included both hospital and GP referrals. Patient in group 2 were GP referrals to GPwSI. Main outcome measures Comparison was made of pre-injection and six week post-injection Oxford shoulder score and a 0–10 pain score. Results Forty-one patients received guided injections (group 1) and 17 unguided (group 2). Group 1 showed a significant mean reduction in the Oxford shoulder score of 9.10 (95% CI 7.07–11.13, P < 0.0001) and a significant change in the mean 0–10 pain score of −3.26 (95% CI −2.51 to −3.88, P < 0.0001). Group 2 also showed significant reduction in the mean Oxford shoulder score of 9.94 (95% CI 6.41–13.47, P < 0.0001) and significant change in the mean 0–10 pain score of −2.94 (−1.95 to −3.93, P < 0.0001). Comparison of groups 1 and 2 for each outcome measure revealed no significant differences. Conclusion Our data confirm the efficacy of steroid injection in the management of subacromial impingement, although no significant difference is found when comparing the two groups. We recommend the continued use of unguided injections, with ultrasound used for more practically difficult cases and where there is diagnostic uncertainty.

The addition of CTV results in the increased detection of thromboembolic disease. CTV combined with pulmonary CTA has a promising role as a quick and efficient test for venous thromboembolism.

Initial data from North America shows reduction in lung cancer-related mortality following the use of CT screening. • Staging with TNM 7 has replaced TNM 6 based on evidence-based outcomes reflecting advances in diagnosis and treatment. • CT remains the workhorse for initial diagnostic imaging in lung cancer; however, the uses for positron emission tomography (PET)-CT are ever increasing with greater sensitivity and specificity for staging. • Endoscopic ultrasound-guided nodal sampling via the airways and oesophagus is replacing the need for surgical mediastinal sampling and preventing unnecessary thoracotomies. • Ultrasound-guided sampling of neck nodes should be considered in those patients with mediastinal adenopathy. • Knowledge of potential surgical procedures and their imaging features is vital for reporting radiologists in order to recognize the potential complications. • Stereotactic body radiotherapy-associated changes include ground-glass opacity, consolidation and fibrosis. PET-CT is a helpful adjunct in the follow-up of these patients. • Radiofrequency ablation, cryoablation and microwave ablation are promising new advances in treatment for those patients unsuitable for surgery, although outcomes remain less favourable.Abstract. Lung cancer-related morbidity has a significant impact on the health economy with a 5-year survival rate of 7-9%. Promising early results have been reported in the use of CT screening to reduce mortality. Significant advances have developed in diagnostic imaging with the ever increasing use of positron emission tomography-CT. Nonsurgical invasive sampling methods have been introduced including the use of endoscopic ultrasound-guided needle aspiration. This has been accompanied by advances in surgical techniques, radiotherapy regimes and chemotherapeutic agents. Treatment with curative intent has also increased the role of follow-up imaging, for which regimes are variable between centres and countries. This article aims to review the current evidence with regard to screening, diagnosis, treatment and follow-up.

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