Necrotising fasciitis of the shoulder following muscular strain.

Necrotising fasciitis is a rare, life-threatening, soft-tissue infection characterised by rapidly spreading inflammation and subsequent necrosis of the muscle, fascia and surrounding tissues. We report a case of necrotising fasciitis originating from the shoulder in a 59-year-old female patient. Necrotising fasciitis of the shoulder is very rare and has a poor prognosis because of its potential to spread to the chest wall. It can occur in otherwise healthy people without any predisposing conditions and could present as muscle strain. Disproportionate pain is the hallmark of this condition. Ultrasound examination and aspiration of fluid from the involved area is a fast and efficient method of reaching the diagnosis.

Rapid nerve recovery following decompression--a case of post-traumatic axonamonosis.

We report a humeral fracture associated with complete radial nerve palsy, where immediate nerve recovery followed decompression. This uncommon type of nerve lesion is referred to as axonamonosis and is not included in the traditional Seddon nerve injury classification.

Knee arthroscopy under local anaesthesia: results and evaluation of patients' satisfaction.

A study of 55 consecutive knee arthroscopies under local anaesthesia was undertaken, in order to evaluate the effectiveness, patient satisfaction and acceptability of the procedure. Knee arthroscopy was performed without a thigh tourniquet under low volume (20 ml) local anaesthesia using half the recommended safe dose of anaesthetic agents, as a single intra-articular injection together with skin infiltration of the arthroscopic portals. The diagnostic accuracy and effectiveness of the procedure was similar to that of surgery under general anaesthesia. Sixty-two lesions were diagnosed and 48 surgical procedures were successfully carried out in 53 patients. All but one of the questioned patients (97 per cent) were satisfied with the procedure which caused little or no discomfort in 94 per cent of cases. It is concluded that knee arthroscopy under local anaesthesia may be considered as a reliable, well tolerated and safe alternative to conventional procedures.

Bone-scintigraphy in painful bipartite patella.

We report the scintigraphic-appearances of painful bipartite patella in 25-year-old man a 2 1/2 years history of unexplained patellar pain. Painful bipartite patella is a rare cause of chronic post-traumatic patellar pain. Bone scintigraphy, by demonstrating increased uptake by the painful accessory bipartite fragment, appears to be an imaging method of choice in the diagnosis of this condition.

Painful bipartite patella following injury.

We report nine rare cases of painful bipartite patella following injury to the knee, in seven non-athletic adults. Patients suffered with persistent anterior knee pain and localized tenderness over the superolateral aspect of the patella for an average of 2 years following injury. The clinical, radiographic and arthroscopic findings are described. Excision of the accessory bipartite fragment resulted in satisfactory relief of pain and complete restoration of the knee function in all patients at a mean follow-up of 10 months (range 3-36 months). Although painful bipartite patella may be considered rare it should be recognized as a cause of post-traumatic anterior pain in the adult.

Aneurysm of the superficial palmar arch. A case report.

We describe a case of compression of the median nerve by an aneurysm of the superficial palmar arterial arch which presented with symptoms of the carpal tunnel syndrome. The traumatic and occupational nature of true palmar aneurysms are discussed.