Neha Nischal - Academia.edu (original) (raw)

Papers by Neha Nischal

Research paper thumbnail of Pes planus intermetatarsal angle to measure flatfoot deformity on dorsoplantar radiographic imaging

Journal of Arthroscopic Surgery and Sports Medicine, Jul 6, 2024

Research paper thumbnail of Tumors and Tumor-like Lesions

Research paper thumbnail of Validity of ChatGPT-generated musculoskeletal images

Skeletal radiology, Mar 4, 2024

Research paper thumbnail of The T1 ratio of marrow (TROM) as a novel tool to identify metastatic from non-malignant marrow lesions of the spine : A pilot study

Brain and Spine, Dec 31, 2022

Research paper thumbnail of Intraoperative radiological imaging: An update on modalities in trauma and orthopedic surgery

Journal of Arthroscopy and Joint Surgery, Dec 31, 2022

Research paper thumbnail of Solid Pseudopapillary Neoplasm of the Pancreas Clinicopathological Characteristics and Long-Term Outcome: a Single-Center Experience

Indian Journal of Surgical Oncology, May 18, 2018

Solid pseudopapillary neoplasm is a rare tumor of the pancreas. These tumors are considered to ha... more Solid pseudopapillary neoplasm is a rare tumor of the pancreas. These tumors are considered to have low malignant potential with good prognosis. Due to its rarity, details about clinical presentation and management of the disease are not very clear. This study aims to share our experience and to describe management of the disease. We retrospectively evaluated patients 13 patients diagnosed with SPT on histopathological examination of resected specimen. Data on their clinicopathological, managementrelated factors, and follow-up was collected. All the patients were females, with a median age of 20 years. Abdominal pain was the most common presentation. The mean tumor size was 6.5 cm and majority of tumors were located in the head region. R0 resection was obtained in all the patients. All patients were disease-free with a median follow-up of 68 months. Excellent prognosis can be achieved with a margin-negative resection in these tumors. Adjacent organ or vascular involvement is not a contraindication for surgical resection.

Research paper thumbnail of Spondyloarthropathy - Is sacroiliac joint imaging sufficient? A study of 431 patients

Indian Journal of Radiology and Imaging, Oct 1, 2019

Background: Sacroiliac (SI) joint involvement (sacroiliitis) is considered as major criteria for ... more Background: Sacroiliac (SI) joint involvement (sacroiliitis) is considered as major criteria for diagnosing Spondyloarthropathy (SpA), although involvement of spine and hip can also occur. The aim of our study was to assess the utility of including sagittal short-tau inversion recovery (STIR) sequence of dorsolumbar spine and coronal STIR/proton density (PD) fat saturated sequence through both hips, to routine SI joint magnetic resonance (MR) imaging protocol, in patients clinically suspected to have SpA. Material and Methods: A retrospective observational study was conducted between February 2013 and February 2018 on clinically suspected SpA patients referred to our department for imaging. The images obtained using this new SI joint protocol were evaluated for findings suggesting SpA diagnosis as per the Assessment of SpondyloArthritis international Society criteria. Other differentials for similar symptoms were also looked for. Results: Of the 431 patients (313 M and 118 F), 255 had features confirming the diagnosis of SpA and 176 had no radiological manifestations of SpA (56 were normal and 120 had other findings to suggest clinical symptoms; e.g., degenerative SpA, Pott's spine, skeletal metastases, early AVN of hip, cysticercus, iliofemoral impingement). 19/255 patients had normal SI joints but other findings to suggest diagnosis of SpA, e.g. romanus lesions, costovertebritis/costotransversitis, pubic symphysitis, inflammatory hip arthropathy, enthesitis, iliofemoral/trochanteric bursitis. 33/61 patients with chronic sacroiliitis had disease activity in spine or hip. Conclusion: Inclusion of sections through dorsolumbar spine and both hips to routine SI joint protocol, helped in identifying: (a) early disease in 19 patients, who had normal SI joints and may have otherwise been missed with routine only SI joint imaging, (b) additional findings in SpA-related sacroiliitis, (c) disease activity in chronic sacroiliitis, and (d) other causes of low back pain and thus helped in further patient management.

Research paper thumbnail of Quantitative Evaluation of the Diffusion Tensor Imaging Matrix Parameters and the Subsequent Correlation with the Clinical Assessment of Disease Severity in Cervical Spondylotic Myelopathy

Asian Spine Journal, Dec 31, 2021

We performed a prospective observational study of 52 patients who were clinically suspected of ce... more We performed a prospective observational study of 52 patients who were clinically suspected of cervical spondylotic myelopathy (CSM), based on the modified Japanese Orthopaedic Association (mJOA) score, and were referred for magnetic resonance imaging (MRI) of the cervical spine. Purpose: To evaluate the quantitative parameters of the diffusion tensor imaging (DTI) matrix (fractional anisotropy [FA] and apparent diffusion coefficient [ADC] values) and determine the subsequent correlation with the clinical assessment of disease severity in CSM. Overview of Literature: Conventional MRI is the modality of choice for the identification of cervical spondylotic changes and is known to have a low sensitivity for myelopathy changes. DTI is sensitive to disease processes that alter the water movement in the cervical spinal cord at a microscopic level beyond the conventional MRI. Methods: DTI images were processed to produce FA and ADC values of the acquired axial slices with the regions of interest placed within the stenotic and non-stenotic segments. The final quantitative radiological derivations were matched with the clinical scoring system. Results: Total 52 people (24 men and 28 women), mean age 53.16 years with different symptoms of myelopathy, graded as mild (n=11), moderate (n=25), and severe (n=16) as per the mJOA scoring system, underwent MRI of the cervical spine with DTI. In the most stenotic segments, the mean FA value was significantly lower (0.5009±0.087 vs. 0.655.7±0.104, p<0.001), and the mean ADC value was significantly higher (1.196.5±0.311 vs. 0.9370±0.284, p<0.001) than that in the non-stenotic segments. The overall sensitivity in identifying DTI metrics abnormalities was more with FA (87.5%) and ADC (75.0%) than with T2 weighted images (25%). Conclusions: In addition to the routine MRI sequences, DTI metrics (FA value better than ADC) can detect myelopathy even in patients with a mild grade mJOA score before irreversible changes become apparent on routine T2 weighted imaging and thus enhance the clinical success of decompression surgery.

Research paper thumbnail of Bone tumor imaging: An update on modalities and radiological findings

Journal of Arthroscopy and Joint Surgery

Research paper thumbnail of Imaging in sports medicine

Journal of Arthroscopy and Joint Surgery

Research paper thumbnail of Authors’ response to the Letter to the Editor

Research paper thumbnail of Authors’ response to the Letter to the Editor: Re-evaluating the role of AI in scientific writing: a critical analysis on ChatGPT

Research paper thumbnail of Periosteitis Ossificans: Largest Case Series with Review of Literature

Indian Journal of Radiology and Imaging

Background Periosteitis ossificans (PO) are rare, benign ossifying surface lesions characterized ... more Background Periosteitis ossificans (PO) are rare, benign ossifying surface lesions characterized by the centripetal ossification with osseous and soft-tissue edema. Their clinicoradiological appearances can easily mimic those of more sinister or infective surface lesion. Objective This study aimed to explore the various anatomical locations and muscle attachment at the site of PO, and evaluate the role of complementary image findings in patients presenting at our tertiary orthopaedic referral center. Patients and Methods A retrospective review of our oncology and radiology databases was undertaken to identify patients with PO reported on radiographs, magnetic resonance imaging (MRI) and computed tomography (CT) over the past 13 years (2007–2020).Patient demographics, sites of PO, muscle attachment at the site of PO, findings on complementary imaging, and clinical management outcome were documented. Results We identified 38 patients with PO with a mean age of 24 years (range: 4–66 ye...

Research paper thumbnail of The Linear Coronal Knee Offset (LCKO)—Preliminary Study of New Method of Measuring Knee Varus/Valgus Malalignment

Indian Journal of Radiology and Imaging

Introduction Considerable attention is focused on preoperative templating of radiological images ... more Introduction Considerable attention is focused on preoperative templating of radiological images in patients undergoing total knee arthroplasty to obtain optimal alignment and outcome. Several radiological measurements have been described. Purpose In this study, we illustrate a new linear measurement: The linear coronal knee offset (LCKO) that can be used to analyze the coronal configuration on long leg alignment radiographs commonly undertaken during preoperative templating. Methods A retrospective search was performed of our Picture Archiving and Communication System and Radiology Information System to identify 100 lower limbs anteroposterior, weight bearing, long leg alignment view radiographs of patients referred to knee clinics over 1 year with knee pain.Demographic details, clinical indication, standard radiological measurement of the anatomical tibiofemoral angle, and the LCKO were measured and data were analyzed using Student's t-test. In addition, intraclass correlation...

Research paper thumbnail of Piggyback Technique—A Safe Way of Performing Rib Biopsy

Indian Journal of Radiology and Imaging

Rib biopsy can be challenging. A spectrum of bone biopsy techniques are available to undertake Ri... more Rib biopsy can be challenging. A spectrum of bone biopsy techniques are available to undertake Rib Bone biopsy and yield a histological specimen. In this technical report, we described a new Piggyback technique of performing rib biopsy to decrease the incidence of pneumothorax and consolidate diagnostic accuracy.

Research paper thumbnail of Imaging of Cartilage and Chondral Defects: An Overview

Life, Jan 28, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Solid Pseudopapillary Neoplasm of the Pancreas

American Journal of Surgical Pathology, 2014

North region (up to 33.7%), probably because of the difficulty to access proper healthcare. The d... more North region (up to 33.7%), probably because of the difficulty to access proper healthcare. The death rates in the other regions varied from 24% to 27%. Conclusions: It is known that the pancreatic cancer has high death rates, which can be proved by the numbers found by the research, that also showed that the difference between the healthcare access in different Brazilian regions can influence the outcome of the disease. This study shows that actions based on the Evidence Based Medicine are needed to lower its death rate, directing more resources to areas in need.

Research paper thumbnail of Ultrasound of the Hook of Hamate Region

Journal of Ultrasound in Medicine

Research paper thumbnail of Performance evaluation of high-resolution Ultrasound and Magnetic Resonance Imaging in diagnosing peripheral nerve pathologies

Research paper thumbnail of Primary Subcutaneous Hydatid Cyst of the Face: A Rare Entity with Emphasis on Radiological Evaluation

Archives of Clinical Infectious Diseases, 2017

Despite being an extremely common disease worldwide, especially in the temperate areas, hydatid d... more Despite being an extremely common disease worldwide, especially in the temperate areas, hydatid disease continues to startle by varying presentations. The current study presented a case of primary hydatid in the subcutaneous region of face of a young patient accurately diagnosed preoperatively by the characteristic of imaging findings on ultrasonography (USG) and comouted tomography (CT) and confirmed on surgery. Although it was a rare site of presentation, the radiological features were essentially the same as elsewhere in the body and could help to make correct decision to manage the patient.

Research paper thumbnail of Pes planus intermetatarsal angle to measure flatfoot deformity on dorsoplantar radiographic imaging

Journal of Arthroscopic Surgery and Sports Medicine, Jul 6, 2024

Research paper thumbnail of Tumors and Tumor-like Lesions

Research paper thumbnail of Validity of ChatGPT-generated musculoskeletal images

Skeletal radiology, Mar 4, 2024

Research paper thumbnail of The T1 ratio of marrow (TROM) as a novel tool to identify metastatic from non-malignant marrow lesions of the spine : A pilot study

Brain and Spine, Dec 31, 2022

Research paper thumbnail of Intraoperative radiological imaging: An update on modalities in trauma and orthopedic surgery

Journal of Arthroscopy and Joint Surgery, Dec 31, 2022

Research paper thumbnail of Solid Pseudopapillary Neoplasm of the Pancreas Clinicopathological Characteristics and Long-Term Outcome: a Single-Center Experience

Indian Journal of Surgical Oncology, May 18, 2018

Solid pseudopapillary neoplasm is a rare tumor of the pancreas. These tumors are considered to ha... more Solid pseudopapillary neoplasm is a rare tumor of the pancreas. These tumors are considered to have low malignant potential with good prognosis. Due to its rarity, details about clinical presentation and management of the disease are not very clear. This study aims to share our experience and to describe management of the disease. We retrospectively evaluated patients 13 patients diagnosed with SPT on histopathological examination of resected specimen. Data on their clinicopathological, managementrelated factors, and follow-up was collected. All the patients were females, with a median age of 20 years. Abdominal pain was the most common presentation. The mean tumor size was 6.5 cm and majority of tumors were located in the head region. R0 resection was obtained in all the patients. All patients were disease-free with a median follow-up of 68 months. Excellent prognosis can be achieved with a margin-negative resection in these tumors. Adjacent organ or vascular involvement is not a contraindication for surgical resection.

Research paper thumbnail of Spondyloarthropathy - Is sacroiliac joint imaging sufficient? A study of 431 patients

Indian Journal of Radiology and Imaging, Oct 1, 2019

Background: Sacroiliac (SI) joint involvement (sacroiliitis) is considered as major criteria for ... more Background: Sacroiliac (SI) joint involvement (sacroiliitis) is considered as major criteria for diagnosing Spondyloarthropathy (SpA), although involvement of spine and hip can also occur. The aim of our study was to assess the utility of including sagittal short-tau inversion recovery (STIR) sequence of dorsolumbar spine and coronal STIR/proton density (PD) fat saturated sequence through both hips, to routine SI joint magnetic resonance (MR) imaging protocol, in patients clinically suspected to have SpA. Material and Methods: A retrospective observational study was conducted between February 2013 and February 2018 on clinically suspected SpA patients referred to our department for imaging. The images obtained using this new SI joint protocol were evaluated for findings suggesting SpA diagnosis as per the Assessment of SpondyloArthritis international Society criteria. Other differentials for similar symptoms were also looked for. Results: Of the 431 patients (313 M and 118 F), 255 had features confirming the diagnosis of SpA and 176 had no radiological manifestations of SpA (56 were normal and 120 had other findings to suggest clinical symptoms; e.g., degenerative SpA, Pott's spine, skeletal metastases, early AVN of hip, cysticercus, iliofemoral impingement). 19/255 patients had normal SI joints but other findings to suggest diagnosis of SpA, e.g. romanus lesions, costovertebritis/costotransversitis, pubic symphysitis, inflammatory hip arthropathy, enthesitis, iliofemoral/trochanteric bursitis. 33/61 patients with chronic sacroiliitis had disease activity in spine or hip. Conclusion: Inclusion of sections through dorsolumbar spine and both hips to routine SI joint protocol, helped in identifying: (a) early disease in 19 patients, who had normal SI joints and may have otherwise been missed with routine only SI joint imaging, (b) additional findings in SpA-related sacroiliitis, (c) disease activity in chronic sacroiliitis, and (d) other causes of low back pain and thus helped in further patient management.

Research paper thumbnail of Quantitative Evaluation of the Diffusion Tensor Imaging Matrix Parameters and the Subsequent Correlation with the Clinical Assessment of Disease Severity in Cervical Spondylotic Myelopathy

Asian Spine Journal, Dec 31, 2021

We performed a prospective observational study of 52 patients who were clinically suspected of ce... more We performed a prospective observational study of 52 patients who were clinically suspected of cervical spondylotic myelopathy (CSM), based on the modified Japanese Orthopaedic Association (mJOA) score, and were referred for magnetic resonance imaging (MRI) of the cervical spine. Purpose: To evaluate the quantitative parameters of the diffusion tensor imaging (DTI) matrix (fractional anisotropy [FA] and apparent diffusion coefficient [ADC] values) and determine the subsequent correlation with the clinical assessment of disease severity in CSM. Overview of Literature: Conventional MRI is the modality of choice for the identification of cervical spondylotic changes and is known to have a low sensitivity for myelopathy changes. DTI is sensitive to disease processes that alter the water movement in the cervical spinal cord at a microscopic level beyond the conventional MRI. Methods: DTI images were processed to produce FA and ADC values of the acquired axial slices with the regions of interest placed within the stenotic and non-stenotic segments. The final quantitative radiological derivations were matched with the clinical scoring system. Results: Total 52 people (24 men and 28 women), mean age 53.16 years with different symptoms of myelopathy, graded as mild (n=11), moderate (n=25), and severe (n=16) as per the mJOA scoring system, underwent MRI of the cervical spine with DTI. In the most stenotic segments, the mean FA value was significantly lower (0.5009±0.087 vs. 0.655.7±0.104, p<0.001), and the mean ADC value was significantly higher (1.196.5±0.311 vs. 0.9370±0.284, p<0.001) than that in the non-stenotic segments. The overall sensitivity in identifying DTI metrics abnormalities was more with FA (87.5%) and ADC (75.0%) than with T2 weighted images (25%). Conclusions: In addition to the routine MRI sequences, DTI metrics (FA value better than ADC) can detect myelopathy even in patients with a mild grade mJOA score before irreversible changes become apparent on routine T2 weighted imaging and thus enhance the clinical success of decompression surgery.

Research paper thumbnail of Bone tumor imaging: An update on modalities and radiological findings

Journal of Arthroscopy and Joint Surgery

Research paper thumbnail of Imaging in sports medicine

Journal of Arthroscopy and Joint Surgery

Research paper thumbnail of Authors’ response to the Letter to the Editor

Research paper thumbnail of Authors’ response to the Letter to the Editor: Re-evaluating the role of AI in scientific writing: a critical analysis on ChatGPT

Research paper thumbnail of Periosteitis Ossificans: Largest Case Series with Review of Literature

Indian Journal of Radiology and Imaging

Background Periosteitis ossificans (PO) are rare, benign ossifying surface lesions characterized ... more Background Periosteitis ossificans (PO) are rare, benign ossifying surface lesions characterized by the centripetal ossification with osseous and soft-tissue edema. Their clinicoradiological appearances can easily mimic those of more sinister or infective surface lesion. Objective This study aimed to explore the various anatomical locations and muscle attachment at the site of PO, and evaluate the role of complementary image findings in patients presenting at our tertiary orthopaedic referral center. Patients and Methods A retrospective review of our oncology and radiology databases was undertaken to identify patients with PO reported on radiographs, magnetic resonance imaging (MRI) and computed tomography (CT) over the past 13 years (2007–2020).Patient demographics, sites of PO, muscle attachment at the site of PO, findings on complementary imaging, and clinical management outcome were documented. Results We identified 38 patients with PO with a mean age of 24 years (range: 4–66 ye...

Research paper thumbnail of The Linear Coronal Knee Offset (LCKO)—Preliminary Study of New Method of Measuring Knee Varus/Valgus Malalignment

Indian Journal of Radiology and Imaging

Introduction Considerable attention is focused on preoperative templating of radiological images ... more Introduction Considerable attention is focused on preoperative templating of radiological images in patients undergoing total knee arthroplasty to obtain optimal alignment and outcome. Several radiological measurements have been described. Purpose In this study, we illustrate a new linear measurement: The linear coronal knee offset (LCKO) that can be used to analyze the coronal configuration on long leg alignment radiographs commonly undertaken during preoperative templating. Methods A retrospective search was performed of our Picture Archiving and Communication System and Radiology Information System to identify 100 lower limbs anteroposterior, weight bearing, long leg alignment view radiographs of patients referred to knee clinics over 1 year with knee pain.Demographic details, clinical indication, standard radiological measurement of the anatomical tibiofemoral angle, and the LCKO were measured and data were analyzed using Student's t-test. In addition, intraclass correlation...

Research paper thumbnail of Piggyback Technique—A Safe Way of Performing Rib Biopsy

Indian Journal of Radiology and Imaging

Rib biopsy can be challenging. A spectrum of bone biopsy techniques are available to undertake Ri... more Rib biopsy can be challenging. A spectrum of bone biopsy techniques are available to undertake Rib Bone biopsy and yield a histological specimen. In this technical report, we described a new Piggyback technique of performing rib biopsy to decrease the incidence of pneumothorax and consolidate diagnostic accuracy.

Research paper thumbnail of Imaging of Cartilage and Chondral Defects: An Overview

Life, Jan 28, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Solid Pseudopapillary Neoplasm of the Pancreas

American Journal of Surgical Pathology, 2014

North region (up to 33.7%), probably because of the difficulty to access proper healthcare. The d... more North region (up to 33.7%), probably because of the difficulty to access proper healthcare. The death rates in the other regions varied from 24% to 27%. Conclusions: It is known that the pancreatic cancer has high death rates, which can be proved by the numbers found by the research, that also showed that the difference between the healthcare access in different Brazilian regions can influence the outcome of the disease. This study shows that actions based on the Evidence Based Medicine are needed to lower its death rate, directing more resources to areas in need.

Research paper thumbnail of Ultrasound of the Hook of Hamate Region

Journal of Ultrasound in Medicine

Research paper thumbnail of Performance evaluation of high-resolution Ultrasound and Magnetic Resonance Imaging in diagnosing peripheral nerve pathologies

Research paper thumbnail of Primary Subcutaneous Hydatid Cyst of the Face: A Rare Entity with Emphasis on Radiological Evaluation

Archives of Clinical Infectious Diseases, 2017

Despite being an extremely common disease worldwide, especially in the temperate areas, hydatid d... more Despite being an extremely common disease worldwide, especially in the temperate areas, hydatid disease continues to startle by varying presentations. The current study presented a case of primary hydatid in the subcutaneous region of face of a young patient accurately diagnosed preoperatively by the characteristic of imaging findings on ultrasonography (USG) and comouted tomography (CT) and confirmed on surgery. Although it was a rare site of presentation, the radiological features were essentially the same as elsewhere in the body and could help to make correct decision to manage the patient.