Ultrasound-based scoring to predict long-term healing in anal fistula: A practical alternative or complementary to the MRI-based Garg scoring system?

The published study highlights an important gap in current practice. While MRI remains the gold standard for postoperative evaluation due to its high sensitivity and specificity, its cost and limited availability in some regions may limit routine use. In this context, the development of a Jabalpur Transperineal Ultrasonography-Based Scoring System (J-TPUSS) represents a pragmatic attempt to bridge this disparity. However, several methodological and interpretative concerns merit consideration, which we have discussed in the letter.