Hereditary multiple exostosis complicated by popliteal artery pseudo-aneurysm and common peroneal nerve palsy

We describe a rare case of a twenty-five-year old male patient with a history of hereditary multiple exostoses who presented with a right popliteal fossa swelling and right foot drop following a mild trauma. The swelling proved to be a popliteal artery pseudo-aneurysm complicating a femoral osteochondroma. The management and surgical treatment are discussed

Comparison of H-reflex latency with conventional motor nerve conduction study in diagnosis of diabetic neuropathy

Distal polyneuropathy is the most common neurologic complication of diabetes mellitus. Prolongation of H-reflex latency could be demonstrated at time when convential motor nerve conduction study may not show an abnormality. The aim of this work was to compare motor conduction study with H-reflex latency in diagnosis of diabetic neuropathy. This study was carried out on 44 patients with diabetes mellitus of both type 1 and type 2, they were 26 males with mean age 47.5 years and 18 females with mean age 43.4 years. A control group of 10 healthy subjects were chosen, six were males and 4 were females, the two groups were matched together as regard the age and sex. The patients and control groups were subjected to thorough clinical evaluation and electrophysiological testing for distal latency of the median and lateral popliteal nerves and their motor nerve conduction velocity as well as the H-reflex latency. Correlations between H-reflex and other variables including motor conduction velocity and type of diabetes were done. The results were: 30 cases showed peripheral sensory affection while 14 patients showed no symptoms of sensory affection, 27 patients showed motor manifestations, 6 patients showed cranial nerve affection and 5 patients showed manifestations of autonomic dysfunctions. The electrophysiological tests showed highly significant difference between control and patients groups regarding median nerve distal latency, median and lateral popliteal nerves motor conduction velocity and very highly significant difference between control and patients groups in H-reflex latency. Comparing H-reflex latency with motor nerve conduction velocity revealed significant superiority of H-reflex latency on motor conduction velocity in both clinical and subclinical cases of diabetic neuropathy. We concluded that H-reflex latency is of great diagnostic value in diabetic neuropathy. Furthermore, it is more sensitive than conventional motor nerve conduction study