These results show that whole body CT in trauma has a high sensitivity and a low rate of missed injuries (2.4%). However, our study only evaluated a subgroup of patients with ISS > 15 and further work is required to assess the use of this investigation for all major trauma patients.

Introduction. Recent changes to primary care trusts' Procedures of Limited Clinical Value (PLCV) policy mean that otolaryngologists must now follow policy rather than exercising clinical judgment when listing patients for tonsillectomy. Objectives. To gauge perception within the general public of when tonsillectomy is acceptable and to compare this to the current policy. Method. All patients or their parents attending the adult and paediatric outpatient ENT departments were asked to anonymously complete questionnaires. Results. One hundred and twenty-five completed questionnaires were collected. Thirty-one percent of respondents thought tonsillectomy should be offered solely on patient request, 19% after one to three bouts, and 35% after four to six bouts of tonsillitis. Only 9% thought the current guidelines were reasonable. Patients who had suffered recurrent tonsillitis or had undergone previous tonsillectomy generally thought tonsillectomy advisable after more bouts of tonsillitis than those who had not. Fourteen patients fulfilled the SIGN guidelines for tonsillectomy for recurrent tonsillitis. Of these, 13 (93%) felt that suffering 4–6 bouts of tonsillitis was reasonable before tonsillectomy. Conclusion. All patients we surveyed who meet the current PLCV and SIGN guidelines regarding the appropriateness of tonsillectomy for recurrent tonsillitis perceive that they are excessive, believing that 4–6 bouts of recurrent tonsillitis are adequate to justify tonsillectomy.

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Prolapsed intervertebral discs are commonly associated with back ache and sciatica. Management is often conservative with analgesia and physiotherapy. Nerve root injections and discectomy procedures are used where conservative measures fail. Majority of patients present with symptoms of pain and motor weakness; however, a few can present as focal myositis of lower limb muscles in the distribution of radiculopathy. MRI scans of limbs are rarely done in these cases but if done can confound the radiologist. Our case report emphasize the importance of multidisciplinary approach for a L3 nerve radiculopathy with confounding clinical presentation of focal lower limb myositis of unknown etiology.

Objective: It is often difficult to pinpoint the affected nerve root/roots from clinical symptoms and Magnetic Resonance Imaging (MRI) alone in patients with chronic cervical radiculopathy and multilevel degenerative changes. MRI often shows degenerative changes at more than one level. Degenerative changes can occur in patients without symptoms and clinical diagnosis. Analyses of referred pain distribution from cervical nerve roots have shown only 50% correlation to the classical sensory dermatome. Surgical treatment of patients with cervical radiculopathy attributed to degenerative disease is associated with moderate outcome results. Our aim was to assess the diagnostic value of cervical selective nerve root blocks (SNRB) in our Trust in surgical decision making. Methods: The data was collected retrospectively from electronic hospital records on CRIS, PACS and NOTIS on consecutive patients who underwent cervical nerve root blocks for diagnostic purpose between 1st Jan 2011 and 31st December 2011. Results: Total of 50 patients had cervical SNRB for diagnostic reasons. It influenced surgical decision making in 84% (42) of these patients and not in 2% cases. 10% did not have any follow up after cervical SNRB. Decision in favour of surgery was made in 71.5% of these 42 patients. Conclusions: In chronic cervical brachialgia, cervical SNRB is extremely influential in surgical decision making, in both whether to operate and which levels scenario.