Khalid Mahmood Khan, Nazila Bano Khalid, Saima Noor, Ahsan Ali, Zuhaib Zafar, Manzoor Mushtaq, Shabbir Naeem.
Under reported vacuum phenomenon: accumulating the burden of disease.
Pak J Radiol Jan ;28(4):267-71.

Background and purpose: In Low-middle income countries like Pakistan, musculoskeletal diseases and renal calculi are prevalent and impart tremendous socioeconomic burden on health care system but receives little attention both for prevention and treatment. Since Computed Tomography Kidney, Ureter & Bladder (CT KUB) are frequently performed for diagnosis and include sacroiliac joints in field of view. The vacuum phenomenon less found in literature is a common finding in sacroiliac joints reflects an indicator of bone degenerative diseases in CT KUB. We hypothesized the prevalence of vacuum phenomenon in spine and sacroiliac joints (SJVP) assuming that it more common and radiologists would not mention frequently on spine images performed for urogenital ailments. Methods and materials : A prospective exploratory study of four months (July to October 2017) sample of seven hundred and thirty referrals to radiology department for CT KUB scans. The age, sex and radiologists reports were reviewed from medical records. Results : Along with Urogenital and renal calculi, CT KUB of almost two third patients 42.2% (n=49) revealed vacuum phenomena in spines of middle aged males and 31% (n=57) sacroiliac joints of adult females. Among 730 patients with vacuum phenomenon only 41% (n=300) were reported. Conclusion: The bone degenerative diseases are prevalent among adult males and females. But the phenomenon is underreported on CT images. The identification may channelize individuals to early diagnostic and cost effective therapeutic interventions to avert the health care cost and implement timely cost effective measures for bone degeneration in masses of low middle income countries. Key words : vacuum phenomenon, bone degenerative diseases, sacroiliac joints, low middle

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