The role of diagnostic ultrasound-guided selective common peroneal nerve block in a patient with negative imaging but with classic neuropathic pain after below knee amputation.

Below-knee amputation neuromas may be hard to detect radiographically. This case report demonstrates that in a below-knee amputee with negative imaging but with classic neuropathic pain, successful diagnostic ultrasound-guided nerve-selective peripheral nerve block may be performed to diagnose the problem; subsequent resection of the neuroma may relieve severe neuropathic pain.

Supraglottic swelling may not correlate with tongue swelling in angiotensin converting enzyme inhibitor-induced angioedema.

Angioneurotic edema of upper airway tissues due to angiotensin converting enzyme inhibitor (ACEI) usage is a known perioperative complication of this class of medications. Swelling can begin rapidly, and typically involves the tongue and oral cavity. We have recently encountered four cases in which supraglottic edema developed after onset of tongue swelling and progressed despite resolving tongue edema. We present a representative case. This observation suggests that all patients with ACEI-induced angioedema should undergo laryngeal fiberoptic examination and appropriate airway management.