Identify and avoid technical pitfalls encountered at adrenal imaging. Describe and avoid interpretive pitfalls, including mimics of adrenal pathologic conditions.Recognize imaging features that may suggest an endocrine disturbance or specific endocrine conditions.

A 67-year-old woman presented with left-sided headache and blurred vision, worse during hypertensive episodes. CT angiography showed a 4 mm left internal carotid artery (ICA) aneurysm incorporating the ophthalmic artery. She passed a test balloon occlusion, so the aneurysm was coil occluded, without immediate complication. Four days postprocedure she experienced sudden loss of vision in the left eye and funduscopy showed central retinal artery occlusion secondary to emboli from the coiled aneurysm. She was treated promptly with intravenous acetazolamide and ocular massage and regained full visual acuity. Thromboembolism to the eye during or after neurointerventional treatment is a relatively rare but devastating complication. This report demonstrates the effectiveness of combined intravenous acetazolamide and ocular massage in dealing with this complication when delivered promptly.

In Trauma and Orthopaedics, a daily Trauma Meeting (TM) occurs, where the previous 24-hour take is discussed and a management plan is decided by the consultant on-take. The post-take ward-round (PTWR) usually follows. In the district general hospital (DGH) where this audit was conducted, clinical incidents and root-cause analysis revealed that the TM/PTWR documentation were suboptimal.We identified gold standards. Variables included clear documentation of PTWR, date/time, consultant on-take, clinician leading the wardround, and management plan. 50 cases were reviewed retrospectively. 72% were seen on PTWR. 47% of these were clearly labeled PTWR. 64% of the cases not seen on PTWR were weekend admissions. Documentation of the previously mentioned fields were also poor.Audit results were presented at the department meeting and a Trauma Meeting/Post-Take Ward Round Proforma was implemented. A prospective re-audit of 50 cases revealed that patients not seen on a PTWR decreased to 18%; 4% of these were weekend admissions. 88% of patients seen had a proforma completed. 18% of all cases did not have a proforma.

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Objectives: The novel CT-TDV scoring system, identifying T3c + disease; presence/absence of tumour deposits and EMVI has been shown to be superior in predicting prognosis when compared to the CT-TNM staging system in the evaluation of colon cancer. Reproducibility of this scoring system between specialist GI radiologists has not been assessed previously. The aim of this study was to assess the inter rater agreement of gastrointestinal radiologists in assessing the novel pre-operative CT-TDV scoring of patients with potentially curable right-sided colon cancer. Methods: 93 right colon cancer pre-operative CT scans were graded as CT TDV ‘good’ versus TDV ‘poor’ by four radiologists. Inter rater agreement was assessed using the intraclass correlation coefficient (ICC) between all four readers and individual readers against the central radiologist using Cohen’s κ statistic. Results: The ICC comparing those graded as TDV ‘good’ versus TDV ‘poor’ for all 93 cases was 0.61 (0.51–0.70) indicating moderate reliability. Individual κ scores across the 93 cases were 0.76, 0.59 and 0.59 (p < 0.001) indicating moderate to substantial agreement. Conclusion: The CT TDV scoring system is reproducible amongst trained gastrointestinal radiologists in the assessment of newly diagnosed right colon cancer. Advances in knowledge: This further validates the clinical utility of the CT TDV scoring system as a prognostic tool to guide the management of patients with potentially curable right colon cancer.