Preaxial polydactyly of the foot in an adult patient diagnosed by X-ray after a trauma.

Polydactyly, or hyperdactyly, is a frequent malformation, with a reported incidence between 0.37 and 1.2 per 1000 live births. Most cases encountered in medical practice are sporadic cases, usually presenting one-sided manifestations. More frequently, polydactyly can be detected prenatally through an ultrasound examination, if not, it is usually diagnosed at birth, during the first physical examination. Although the clinical diagnosis is relatively easy in patients with manifest cases, it can sometimes be present with mild or partial forms that are not clinically evident on physical examination, resulting in later diagnosis and treatment. We reported a particular case of polydactyly of the foot not clinically manifest, diagnosed in a 39-year-old Caucasian Male patient with a history of recurrent localized pain in the big toe often associated with subungual bleeding, since he was a child who came to our emergency room following a car accident. Polydactyly is a frequently reported congenital malformation which may present in many different varieties of deformities. In this case, the X-ray, which was required after a car accident, leads to the incidental diagnosis of polydactyly in an adult patient. As described, because of the functional limitations related to this malformation, as well as to limit recurrent pain, and subungual anomalies, the patient underwent to a surgical correction to improve its quality of life.

Basal ganglia calcification: a Fahr's disease case report.

Idiopathic basal ganglia calcification (IBGC), known as Fahr's disease, is a rare neurological disorder characterized by metabolic, biochemical, neuroradiological and neuropsychiatric alterations caused by symmetrical and bilateral intracranial calcifications. The disease has, in most cases, an autosomal dominant pattern of inheritance and genetic heterogeneity. Overlap of neuropsychiatric symptoms is common with movement disorders accounted for 55% of the manifestation. Here we present the case of a 58-year-old woman, presenting to the emergency department because of an accidental fall. Her past medical history was unremarkable and she denied any neurological symptoms a part from insomnia and anxiety. Patient was sent to the emergency department to perform a Brain Computed Tomography (CT) exam that showed bilateral symmetrical calcifications in cerebellar white matter, the corpus striatum, the posterior thalami, and the centrum semiovale of both cerebral hemispheres. Beeing a case of IBGC without relevant symptoms, diagnosis was mainly obtained thanks to the characteristics features of CT examination.