Pedal acrometastasis secondary to urothelial carcinoma masquerading as Charcot arthropathy in a patient with diabetes.

A woman in her 80s with known diabetes mellitus and bladder cancer presented to her general practitioner (GP) with pain and swelling in her left foot following trauma. Initial radiographs were reported as normal, prompting a diagnosis of a simple sprain and conservative management. Three months later, the patient was referred to the orthopaedic team due to progressively increasing pain and swelling. Repeat X-rays revealed lytic lesions in both the talus and navicular bones; MRI confirmed the presence of a lytic and proliferative defect in the mid-foot, which was reported as acute Charcot arthropathy with superimposed infection. This was also considered the most likely diagnosis when imaging was reviewed in two separate multidisciplinary team) meetings. However, biopsy demonstrated that the cause of the presentation was in fact acrometastasis from urothelial carcinoma, an infrequently described entity.

Spontaneous resolution of superior medial geniculate artery pseudoaneurysm following total knee arthroplasty.

Vascular injury after total knee arthroplasty is a rare event with significant morbidity. To date there are a handful of cases of pseudoaneurysms affecting the popliteal artery and cases involving one of the geniculate arteries are even rarer. Most case reports involving injuries to the geniculate vessels have reported surgical intervention to treat the condition. We report a case where injury to the superior medial geniculate artery with formation of pseudoaneurysm resolved without any surgical intervention.

Posterior dislocation of the shoulder with ipsilateral humeral shaft fracture: A case report and review of literature.

Isolated posterior dislocation of the shoulder with ipsilateral humeral shaft fracture is a rare combination. Three cases of such co-existence have been reported so far. We report a fourth case and review the literature. Our aim is to highlight the importance of this rare co-existence. A high index of suspicion is necessary to diagnose posterior dislocation of the shoulder as most concentration is on the humeral shaft fracture. Delayed diagnosis has a poorer prognosis.

Arthroscopic evaluation of intra-articular haemangiomatous lesions: a technical note.

We are describing an arthroscopy tip, which is helpful in suspected/diagnosed cases of intra-articular haemangioma of the knee. Intra-articular haemangiomas of the knee are a rare but known condition. Arthroscopy or MRI can be used for diagnosis. Arthroscopy was performed in a case of haemangioma diagnosed on MRI performed for anterior knee pain. Appearances of the haemangioma were entirely different when hydrostatic pressures inside the knee joint were different. The picture with bright strawberry coloured haemangioma was seen when lowered hydrostatic pressure in the knee allowed the haemangioma to fill up, defining its full extent. The appearance of the same haemangioma changed to a pale appearance when we allowed hydrostatic pressure to build up inside the knee. We recommend that when dealing with intra-articular haemangiomas of the knee, arthroscopy should be performed under low hydrostatic pressure for better and complete visualisation of the haemangioma, which will prevent incomplete treatment.