The morphology of cyamella and its prevalence in Turkish society.

OBJECTIVE: The aim of this study is to determine the prevalence and morphometry of cyamella, one of the sesamoid bones around the knee joint. PATIENTS AND METHODS: In this retrospective study, a total of 9,500 plain/digital radiographs of 6,500 patients over the age of 18 who applied to Elazig Fethi Sekin City Hospital between January 2021 and January 2022 were examined. RESULTS: Examinations revealed cyamella in a total of 76 (0.8%) knees in the direct X-ray images of 49 (0.75%) patients. Eighteen (36.74%) of the patients with the presence of cyamella were males, and 31 (63.26%) were females. The mean age of the patients with cyamella was 50.9±12.9. Twenty-seven (55.1%) of the 49 cyamella were bilateral; seven (14.3%) were in the right knee, and 15 (30.6%) were in the left knee. The comparison of cyamella sizes between genders revealed a statistically significant difference in the transverse measurements only (p=0.015) in the right knee, while a statistically significant difference was found in all 3 parameters (p=0.032 for thickness; p=0.04 for transverse; p=0.026 for length) in the left knee. CONCLUSIONS: We believe that sufficient knowledge regarding the prevalence and distribution of cyamella in patients presenting with the complaint of knee pain and its differentiation from fabella, another sesamoid bone in the same region, as well as other anatomical structures, will aid an early and accurate diagnosis.

Chronic appendicitis: the process from pre-diagnosis to pathology.

OBJECTIVE: Chronic appendicitis (CA) is a rare medical condition. CA is characterized by a less severe and almost continuous abdominal pain. It has a clinical picture lasting longer than 1-2 days and extending over weeks, months, even years. The exact etiology of CA is unclear. Certain resources have reported it as the cause of partial obstruction in the lumen of the appendix. PATIENTS AND METHODS: Our study was carried out with the approval of the Clinical Research Ethics Committee. A retrospective analysis was performed between August 2018 and March 2020. RESULTS: It was determined that 207 appendectomies were performed during the retrospective scan period. The data of 182 of these patients could be accessed fully and we could get answers to the criteria we thought. Only 8 of the patients screened were likely to be diagnosed with chronic appendicitis in the preoperative period. CA was found in 1 of the 8 patients (12.5%) who underwent surgery after a preliminary diagnosis of CA. Two patients were reported as malignant (25%), 3 patients (37.5%) as reactive lymphoid hyperplasia, and 1 patient as peri appendicitis (12.5%). Bleeding and congestion were reported in the last patient (12.5%). CONCLUSIONS: The diagnosis of chronic appendicitis is made by pathological examination. It may not always be possible to consider "chronic appendicitis" as a preliminary diagnosis. This should still be kept in mind. In our opinion, it is a bit difficult to make a preliminary diagnosis of chronic appendicitis and make a surgical decision. We believe that controlled and prospective studies can shed more light on chronic appendicitis.