The SA Journal of Radiology is the official journal of the Radiological Society of South Africa and the Professional Association of Radiologists in South Africa and Namibia. The SA Journal of Radiology is a general diagnostic radiological journal which carries original research and review articles, pictorial essays, case reports, letters, editorials, radiological practice and other radiological articles.

This case report presents the clinical evaluation of an 11-year-old boy with a unilateral polypoid nasal mass causing nasal obstruction, facial asymmetry, and intermittent epistaxis. His clinical picture raised concerns of a juvenile nasopharyngeal angiofibroma; however, further imaging and histopathological evaluation ultimately confirmed the diagnosis of allergic fungal rhinosinusitis (AFRS). Although this patient was younger in age than those traditionally associated with AFRS, classical features present on both computed tomography (CT) and magnetic resonance imaging (MRI) aided in his diagnosis and management. This case underscores the importance of a comprehensive diagnostic approach when evaluating unilateral sinonasal masses in paediatric patients, specifically in atypical presentations where the diagnosis of AFRS may not initially be considered. It highlights the critical role of imaging as a diagnostic tool, specifically CT and MRI, which were pivotal in the work-up and management of this case. Additionally, the need for caution during biopsies of sinonasal masses in children is emphasised, as there is potential for catastrophic bleeding in vascularised masses such as juvenile nasopharyngeal angiofibroma. This case demonstrates that AFRS can occur in younger children, highlighting the need to include this in the differential diagnosis, even in patients outside of the traditionally described age group.

Background: Little is known about the impact of coronavirus disease 2019 (COVID-19) on South African interventional radiology (IR) services. This study aimed to assess the influence of COVID-19 on IR procedures at a tertiary-level public sector South African (SA) hospital. Methods: A retrospective audit of IR procedures over three 9-week periods in 2020: Period (1) pre-strict lockdown (23 January–25 March), period (2) strict lockdown (26 March–27 May) and period (3) post-strict lockdown (28 May–30 June). Data were captured and stratified by patient demographics, procedure indication, nature (vascular or non-vascular), time (normal or after-hours) and location (IR suite or ward). Calculated incidence rates of categories per period were performed and then compared between the three periods. Results: There were 288, 218 and 204 procedures performed in periods 1, 2 and 3, respectively, with no significant proportional variation in gender, age, after-hours or ward procedures across the periods. During period 2, the overall (n = 218, p = 0.002), non-vascular (n = 148, p = 0.001) and vascular procedures (n = 70, p = 0.999) decreased by 24.3%, 29.8% and 9.1%, respectively. During period 3, the overall (n = 204, p = 0.496) and non-vascular (n = 122, p = 0.590) procedures declined by a further 6.4% and 17.6%, respectively, while vascular procedures (n = 82, p = 0.410) increased by 17.1%. In period 3, the overall (n = 204, p = 0.001) and non-vascular procedures (n = 122, p ≤ 0.001) were 29.1% and 42.2% lower than period 1 levels, whereas vascular procedures (n = 82, p ≥ 0.999) demonstrated the so-called ‘rebound phenomenon’, exceeding period 1 by 6.5%. Conclusion: COVID-19 pandemic impacted non-vascular and vascular IR procedures with variable difference between periods of strict lockdown and post-strict lockown. This affords a perspective on the emerging role of IR in health systems across the African continent. Contribution: This study provides unique insights into the impact of COVID-19 on SA IR services.