Schnitzler’s metastasis – haematogenous or lymphatic spread of gastric carcinoma to the rectal wall – is a rare entity that radiologically closely mimics primary rectal adenocarcinoma, creating a risk of misdiagnosis and inappropriate treatment. A 57-year-old woman presented with progressive constipation, tenesmus and rectal discomfort. Contrast-enhanced CT demonstrated circumferential gastric wall thickening, alongside circumferential rectal wall thickening with avid mucosal enhancement. Pelvic MRI revealed submucosal rectal wall thickening with preserved mesorectal fat planes and no significant diffusion restriction. Endoscopic biopsy confirmed metastatic adenocarcinoma of gastric origin. Contribution: Schnitzler’s metastasis should be considered in any patient with upper gastrointestinal malignancy presenting with rectal symptoms. Combined CT and pelvic MRI can assist in accurate characterisation, extent assessment and identification of the gastric primary.
Background: The national radiology curriculum in South Africa lacks procedural and content-specific detail. Most recent graduates are expected to find work in the private sector, but little is known about the spectrum of interventional procedures performed in this sector by radiologists without interventional subspecialist training. Objectives: To assess interventional radiology exposure and preparedness for private practice among recent graduates in South Africa who do not pursue interventional subspecialisation. Method: One questionnaire was distributed to private-practice radiologists without interventional subspecialisation, assessing the range of interventional procedures they perform, and another to recent radiology graduates, evaluating their self-reported competencies acquired during training. Results: Hepatic or pancreatic biopsy, renal biopsy, lumbar puncture and abdominal abscess drainage were frequently performed procedures in private practice. Recent graduates reported the highest exposure rates and self-reported competence in these procedures. Lower frequencies and self-reported competence were reported for biliary procedures, percutaneous nephrostomies and vascular procedures. Conclusion: This exploratory, respondent-based study suggests partial alignment between South African radiology registrar training and the interventional procedures commonly encountered in private practice by radiologists without interventional subspecialisation. These preliminary interpretations support the case for a revised national curriculum that will improve consistency across training institutions. Contribution: Heterogeneity in registrar training in interventional radiology highlights the need for a national South African curriculum that provides adequate procedural and content-specific detail.
Left ventricular (LV) pseudoaneurysm is an uncommon, life-threatening sequela of myocardial injury, defined by contained rupture of the ventricular free wall by pericardium or scar tissue rather than intact myocardium. Unlike true aneurysms, pseudoaneurysms carry a rupture risk of 30%–45% and a 1-week mortality of 48% in medically managed patients, making prompt diagnosis and accurate differentiation critical for patient survival. Multimodality imaging – chest radiography, echocardiography, CT and cardiac MRI (CMR) – is indispensable in assessing morphology, haemodynamic impact, tissue characterisation, thrombus burden and systemic complications. Cardiac MRI serves as the reference standard for differentiating pseudoaneurysm from true aneurysm and for risk stratification. Contribution: This case series highlights the pivotal role of imaging in the surgical and conservative management planning of LV pseudoaneurysm.
Padel, a fast-paced, high-intensity racquet sport, is associated with a wide range of musculoskeletal injuries. These injuries can range from acute traumatic events, such as ligament tears and fractures, to chronic overuse syndromes, such as tendinitis and stress fractures. The use of imaging plays a crucial role in the diagnosis and management of these conditions. A thorough understanding of the sport’s biomechanics and injury patterns is essential for prompt and targeted intervention. While plain radiographs are useful for identifying fractures, ultrasonography is particularly effective for visualising soft tissue injuries. CT can provide detailed insight into complex fractures, while MRI excels in the evaluation of subtle bone and soft tissue injuries that may not be visible on other imaging modalities. This article reviews common padel-related injuries, their biomechanics and the roles of various imaging methods in their assessment.
