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E1258. Musculoskeletal CT in Sub-Saharan Africa: Review of Typical Pathology Encountered at a Rural Kenyan Teaching Hospital
Authors
  1. Kalie Wood; Columbia University
  2. Ndege Omoi; Tenwek Hospital
  3. John Weston; Tenwek Hospital
  4. Bryan Cheng; Kaiser Permanente San Diego
  5. Stanley Cheng; Kaiser Permanente San Diego; Tenwek Hospital
Background
Since the 1980’s, computed tomography (CT) scans have become a mainstay of diagnostic imaging in developed countries. It is a critical first-line diagnostic tool for a wide variety of disease states including musculoskeletal (MSK) imaging. For developing countries, the cost and infrastructure requirements of CT has delayed its wide deployment. In the past decade, however, the diminishing cost of CT equipment and infrastructure improvements have allowed CT to be deployed more widely in developing countries, significantly improving access to advanced imaging and advancing medical care. This presentation will review common and uncommon disease entities encountered in a rural Kenyan teaching hospital and the corresponding CT appearance. In this setting, patients frequently present with uncommon or unusually advanced presentations of diseases rarely seen in developed countries. This presentation will also describe the limitations and challenges in diagnostic imaging in low-resource settings.

Educational Goals / Teaching Points
1) Review the common and uncommon musculoskeletal pathology encountered in a rural sub-Saharan Africa teaching hospital 2) Understand the limitations and challenges in MSK diagnostic imaging in rural Africa and similar settings in the developing world 3) Increase radiologist awareness of global health needs in imaging and future opportunities for development

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Chronic Osteomyelitis Tuberculous osteomyelitis of spine (Pott’s Disease) Soft tissue tumors Bone tumors High energy traumatic osseous injury—pelvis, knee

Conclusion
Over the past decade, CT has become more readily available in developing countries and has significantly advanced diagnosis and treatment. Patients in rural Africa frequently present with uncommon or more advanced pathology than seen in developed countries such as chronic osteomyelitis, tuberculous osteomyelitis, and advanced stage neoplasms. Limitations and challenges of diagnostic imaging in low-resource settings of the developing world include poor access to advanced imaging and limited availability of MRI. Future avenues for diagnostic imaging development in the developing world include training of in-country radiologists and expanding access to MRI.