Bio

Publications


2017

D, M'oka, I.M. M, C. O.  2017.  THE SPECTRUM OF RADIOGRAPHIC AND SONOGRAPHIC FINDINGS IN PATIENTS WITH SHOULDER PAIN AT THE DEPARTMENT OF DIAGNOSTIC IMAGING AND RADIATION MEDICINE, UNIVERSITY OF NAIROBI. EAOJ. 11(1):12-21. AbstractAJOL

Background: Shoulder pain is a common complaint. Prevalence estimates vary from 6.9% to 26% in the general population. The most frequent cause of shoulder pain is rotator cuff disease. Shoulder radiography is the primary imaging modality in shoulder pain but is limited in the evaluation of the soft tissues. MRI is the chief modality used in the evaluation of shoulder soft tissues both locally and elsewhere but is limited by cost and availability. Shoulder ultrasonography is a cost effective modality for evaluating the soft tissues but is underutilized locally. No data is available in our local population regarding spectrum of findings in shoulder radiographs and ultrasound.
Objective: This study was designed to determine the spectrum of shoulder radiographic and sonographic findings in patients with shoulder pain.
Setting: Department of Diagnostic Imaging and Radiation Medicine, University of Nairobi. It is located within the old wing of Kenyatta National Hospital.
Design: This was a cross sectional descriptive study.
Subjects: A total of 72 patients with shoulder pain who were referred for shoulder radiographs.
Method: The study was conducted over a period of four months between the months of January 2016 to April 2016. Seventy two consecutive patients with shoulder pain referred for shoulder radiographs had a complementary shoulder ultrasound scan done and findings of both examinations recorded in the data collection form. Statistical analysis of the findings was then done using SPSS version 20 IBM. No surgery findings were available to correlate with the imaging findings.
Results:. Radiographs identified abnormalities in 36 (50%) patients’ majority of which were degenerative changes. Ultrasound identified abnormalities in 57 (79%) patients with the bulk of lesions seen within the rotator cuff. There was statistically significant association between presence of greater tuberosity degenerative changes and rotator cuff tears (p<0.001).
Conclusion: The combination of shoulder radiography and ultrasound significantly increased the diagnostic yield by evaluating both osseous and soft tissue components. These findings aim to increase the awareness and utility of shoulder ultrasound locally.

2014

HA, N, GO O, MD J, FMT O, IM M.  2014.  Patterns of knee, hip and hand osteoarthritis in Kenyatta National Hospital. EAOJ. 8(2):60-63.AJOL

2010

I.M., M, PE EKWOM, G OYOO, E A.  2010.  Ekwom PE, Oyoo G, Amayo E and Muriithi IM. Prevalence and Characteristics of Articular Manifestations in Human Immunodeficiency Virus infection. EAMJ. 2010;87:408-414.. EAST AFRICAN MEDICAL JOURNAL. : EAMJ Abstract

Background: Articular manifestations have been reported in HIV infection with a prevalence ranging from 2.5 to 68%.

Objectives: To determine the prevalence, types and characteristics of articular manifestations in the anti-retroviral treatment naive HIV infected patients.

Design: Cross sectional descriptive study.

Setting: Comprehensive care clinic (HIV outpatient clinic) at the Kenyatta National Hospital (KNH) from October 2007 to March 2008.

Subjects: One hundread and ninety three patients; 135 females and 58 males, aged between 19 to 65 years with Human immunodeficiency virus (HIV) infection who were naive to anti - retroviral drug therapy.

Main outcome measure: Presence of articular manifestations that included HIV associated arthritis, HIV associated spondyloarthropathies, HIV associated arthralgia, painful articular syndrome and avascular necrosis.

Results: Thirty three of these 193 patients had articular manifestation with a prevalence of 17.1 %. The type prevalence was; HIV associated arthralgia, 15.6%; undifferentiated spondyloarthropathy, 1 % and HIV associated arthritis; 0.5%. Their mean age was 36± 9 years, range 23-63 years; majority were female, male to female ratio of 1: 2.3 and the majority were in World health organization (WHO) clinical staging of HIV infection, class II and III with a mean CD4 cell count of 330 cells/mm3. Seventeen (51.5%) of the
patients with articular disease had oligo - articular presentation, 10(30.3%) mono-articular while 6(18.2%) had poly - articular presentation. The mean duration of joint pains was 53.3 days (range of 2-365 days). Six (18.2%) of these 33 patients missed work, home making activities or school due to the articular disease.

Conclusion: Articular manifestations are common in HIV infection with a prevalence of 17.1 %. HIV associated arthralgia was the most common manifestation. Majority of these patients were female, male to female ratio of 1: 2.3. The mean age of these patients was 36 years with a mean CD4 cell count of 330 cells/mm3 with 18.2 % of them missing school or work.

MATHENGE, DRMURIITHIIAN, NTHAMBI DRMWANGOGLADYS.  2010.  Mwango GN, Muriithi IM. Wandering Spleen: Case Report. EAMJ.2010;87:84-86. . EAST AFRICAN MEDICAL JOURNAL. : EAMJ Abstract
Wandering spleens are rare clinical entities found more commonly in women aged 20-40 years. We report one such case found in a 24-year-old nulliparous woman who presented with low abdominal pains of sudden onset and splenomegaly. An emergency abdominal CT scan showed an enlarged spleen located in the right lumbar region and extending into the pelvis. There was a long splenic pedicle containing tortuous vessels. A review of literature and the postulated aetiological factors and associations are discussed.
MATHENGE, DRMURIITHIIAN, KWAMBOKA DRONYAMBUCALLEN.  2010.  Onyambu CK, Muriithi IM, Ngare SM. Cerebral Venous Sinus Thrombosis: A Report of Two Cases. EAMJ.2010;87:220-224. . EAST AFRICAN MEDICAL JOURNAL. : EAMJ Abstract
Cerebral venous sinus thrombosis is an uncommon yet potentially life threatening condition which is often under-diagnosed or misdiagnosed because of the variability of the clinical signs and symptoms. The imaging findings are often subtle thus the need for a high index of suspicion. The superior sagittal and transverse sinuses are the most frequently involved. The correct diagnosis of cerebral venous thrombosis relies on neuroimaging studies. The two cases reported highlight the fact that the radiologist may be the first clinician to suspect and diagnose this condition. This ultimately affects prognosis as early diagnosis and treatment reduces morbidity and mortality.

2009

MATHENGE, DRMURIITHIIAN, G DRKIBOIJULIUS.  2009.  Kiboi JG, Muriithi IM. Vertex Epidural Hematoma Manifesting with Bilateral Upper Limb Decerebrate Posture: Case Report. EAMJ.2009;86:300-304. Abstract available at http://ajol.info/index.php/eamj/article/view/54143.. EAST AFRICAN MEDICAL JOURNAL. : EAMJ Abstract
Vertex epidural haematomas (VEDH) are rare and difficulties are encountered in diagnosis and management. This is a case report of a patient with a vertex epidural haematoma who presented with signs of severe head injury with upper limb decerebrate posture. We discuss the challenges of radiological investigation and neurosurgical management of VEDH.

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