Hourglass epidermoid inclusion cyst: an unusual clinical presentation

Although hourglass epidermoid inclusion cysts have been reported in the cranial region, they have not been reported elsewhere in the body. We report a case of an epidermoid inclusion cyst that was excised completely.

Compartment syndrome of the thigh. A case report and review of the literature

A case of compartment syndrome of the thigh following a gunshot injury that resulted in significant morbidity is presented. Early diagnosis of this uncommon condition requires a high index of suspicion in order to reduce morbidity and mortality. Timely diagnosis, emergency three-compartment decompression, prophylaxis against reperfusion syndrome and aggressive rehabilitation are necessary for a favourable outcome. (AU)

Blood pressure in Jamaican children: relationship to body size and composition

Blood pressure levels in adults and children are related to body size and composition, but some of these relationships are unclear and they have been incompletely described in the Jamaican population. In a cross-sectional survey of 2,332 school children (6-16 years old; 1,046 boys, 1,286 girls), we measured systolic and diastolic blood pressure and pulse rate, and explored their relationship to weight, height, and waist, hip and mid-upper arm circumferences. The effect of these and other derived measures of body composition on blood pressure was explored in univariate and multivariate analysis. Blood pressure increased with age in both boys and girls, although the increase was greater for systolic than for diastolic blood pressure. The increase of systolic blood pressure among boys continued after age 11 years, but that for girls levelled off. Height and weight were the major predictors of blood pressure, but were highly correlated with each other and with all measures of body composition. Age, height and height-sex interaction explained 11.4 percent of systolic blood pressure variation, and the largest incremental contribution to this model was provided by the addition of body mass index or hip circumference, each explaining an additional 2.6 percent of the variance. Lean body mass made a larger contribution to blood pressure than percent fatness. Blood pressure in Jamaican children rises with age and this rise may be steeper in boys than girls. Blood pressure variation is significantly related to several measures of body composition including measures of fatness and fat free masses.(AU)

Leptin concentration in women is influenced by regional distribution of adipose tissue

Leptin concentration in humans are increase with obesity, and women have higher leptin concentration than men. This sex difference reflects the greater fat mass of women. However, there is evidence that factors other than the size of the adipose tissue mass contribute to serum leptin concentrations. This study was undertaken to determine whether anthropometric factors influenced leptin concentrations in our population. Leptin concentrations were measured in 375 persons from a population study of hypertension and diabetes for whom body-composition data (bioelectrical impedance analysis and anthropometry) were available. Serum leptin concentrations were more than four times higher in women than in men (18.5 ñ 13.9 compared with 3.8 ñ 3.5 ng/L, P < 0.0001). In individuals with comparable body mass indexes, these differences persisted after adjustment for either percentage fat (P < 0.05) or fat mas (P < 0.0001) by multivariate-regression analysis. After fat mass was adjusted for, the serum leptin concentration in both men and women was independent of waist circumference but in women was associated with hip circumference. Hip circumference is a proxy measure of peripheral fat and these results suggest that the larger hips of women may contribute to the sex difference in serum leptin concentration.(AU)

Idiopathic chondrolysis of the hip

The radiographic changes in nine cases of chondrolysis of the hip joint are described. The series consists of eight Negro girls and one Indian girl, whose ages ranged from eleven to eighteen years. The incidence of periarticular osteoporosis, joint space narrowing, erosion of articular cortex, femoral head enlargement, increase in width of the femoral neck and growth plate narowing are reported. The difficulty in the diagnosis of chronic monarticular disease of the hip is stressed and the observed changes are discussed with particular reference to monaticular rheumatoid arthritis. The material presented supports the view that `chondrolysis of the hip' is a distinct entity (AU)

Haemoglobin SC disease in Jamaica

A skeletal survey was carried out on 84 cases of haemoglobin SC disease. The radiological features noted were increased translucency of bone, abnormal trabecular pattern, medullary expansion, wide vascular channels in phalanges, and radiological evidence of infarction, both medullary and cortical. The frequency of bone lesions thus demonstrated increased with age. The most characteristic lesions in this region were those of vascular necrosis; contributing factors such as the high haemoglobin level characteristic of the condition are discussed. An interesting feature was the lack of correlation betweeen clinical severity and degree of radiological change. (AU)

Conditions of the hip associated with hemoglobinopathies

In the Western hemisphere where malaria and parasitic infection is rare, the complications of the abnormal hemoglobins are those essentially of infarction. Hyperplastic changes never reach the extent seen in West Africa, infection is a less serious problem, patients survive into adult life and the hip joint produces a large proportion of the orthopedically crippled. Treatment follows the same lines which would be adopted in a patient with avascular necrosis of the femoral head with normal hemoglobin. The prognosis is worse because the age of onset is usually later resulting in slower and less complete restoration to normalcy. Special care in the general management of patients during operations is essential, particularly the avoidance of excessive blood loss or anoxia which may precipitate a crisis (summary)

Radiological observation on an alveolar soft-part sarcoma complicated by trauma and myositis ossificans

The alveolar soft-part sarcoma is a rare tumour that has recently been identified. It resembles chemodectomas and arises from primitive nerve cells. It differs from chemodectomas in its location and in its more malignant behaviour. The tumour was highly vascular and similar in appearance to chemodectomas. The author's patient complained of symptoms after an injury that was complicated by the development of myositis ossificans. The possible relationship between trauma and the development of the tumour is discussed. (AU)

Extrapelvic enodometriosis presenting as unusual swellings of the buttock and thigh

We present the first case of extrapelvic endometriosis (EPE) presenting as combined swellings of the thigh and buttock in 28-year-old nulliparous woman. The diagnosis was aided by the history of cyclical symptoms, needle aspirate, ultrasonography and computed tomography scan and was confirmed by histological analysis of the exercised specimens. Of note, laparoscopy showed the pelvis to be free of gross disease. Surgical excision combined with hormonal suppression therapy proved adequate treatment in preventing recurrence as well as the complications of wound implantation. (AU)