The cause of severe hypercalcaemia resistant to pamidronate treatment: subcutaneous fat necrosis with no visible skin lesion.

Subcutaneous fat necrosis (SCFN) is an uncommon cause of neonatal hypercalcaemia. It is usually seen in neonates after a complicated delivery within the first month of life. While uncommon, hypercalcaemia can be fatal. It is characterised by red-purple plaques in fatty points along with firm subcutaneous nodules. Rarely, SCFN may cause severe hypercalcaemia with no visible skin lesion. In this rare case, we report severe infancy hypercalcaemia without characteristic skin lesion on first physical examination, unresponsive to hydration, diuretic, prednisolone and standard dose of pamidronate treatment. As timely diagnosis and treatment are so important, this complication should be kept in mind even in such clinical presentations.

Gray Scale Histogram Analysis of Carpal Tunnel Syndrome with Ultrasonography.

PURPOSE: In this study, we aim to evaluate the diagnostic value of echogenicity ratio with histogram analyses. MATERIALS & METHODS: This retrospective study was performed on 22 patients with 44 hands. The patients had clinical presentations consistent with CTS, in at one hand. Quantitative ultrasound scanning and image capture were completed using a diagnostic sonography machine. For gray scale histogram analysis, image J software was used. RESULTS: Mean flexor tendons histogram analysis echogenicity/Mean median nerve histogram analysis echogenicity was significantly high for 1,7 cutoff value. CONCLUSION: Mean FTE/MNE ratio may be a useful sonographic parameter for CTS.

A case of headache, double vision and ptosis in emergency department: Tolosa-Hunt syndrome.

Headache and double vision symptoms can be seen especially neurological and optical problems. We present Tolosa-Hunt syndrome in a 34-year-old female patient who presented to the emergency department (ED) with the complaints of unilateral severe headache, double vision and ptosis, presented asymmetric contrast enhancement in the right superior cavernous sinus on MR. This pain was reduced with steroid therapy. Pulse steroid therapy of 1 mg/kg/day was planned based on the patient's clinical manifestation, MRI findings and presumed diagnosis of THS. It was observed at patient's follow-up that there were occasional headache, ptosis and double vision were disappeared and MRI findings were regressed. In the differential diagnosis of patients presenting to the ED with the complaints of headache and double vision, rare pathologies such as THS should be considered in addition of common pathologies such as neurological and ocular diseases.