Unilateral peripheral slow flow phenomenon without significant stenosis in lower extremity artery: can primary peripheral slow flow be a new phenomenon?

Peripheral artery disease affects nearly a quarter billion of the world's population, and it is one of the most important causes of decreased quality of life. Primary peripheral slow flow without significant stenosis in peripheral arteries has not been previously reported in the literature. In this case report, we present a slow flow phenomenon that extended from the right external iliac artery to the distal peripheral bed observed during peripheral angiography in a patient who exhibited pain and claudication in the right lower extremity after walking 50 m. Medical treatment provided symptomatic improvement in coronary slow flow and led to a decrease in claudication. Future randomised controlled studies conducted on patients with suspected peripheral slow flow phenomenon would increase our knowledge on both the aetiology and treatment of this condition.

Gaucher's disease in a patient presenting with hip and abdominal pain

Summary Gaucher's disease is characterized by glucocerebroside accumulation in the cells of the reticuloendothelial system. There are three subtypes. The most common is type 1, known as the non-neuropathic form. Pancytopenia, hepatosplenomegaly and bone lesions occur as a result of glucocerebroside accumulation in the liver, lung, spleen and bone marrow in these patients. Findings associated with liver, spleen or bone involvement may be seen at radiological analysis. Improvement in extraskeletal system findings is seen with enzyme replacement therapy. Support therapy is added in patients developing infection, anemia or pain. We describe a case of hepatosplenomegaly, splenic infarction, splenic nodules and femur fracture determined at radiological imaging in a patient under monitoring due to Gaucher's disease.

Retroperitoneal haemangiopericytoma.

A 55-year-old woman, diagnosed with a renal mass by abdominal ultrasonography (USG) in an external medical centre, presented to our hospital. The medical history was unremarkable except for diabetes mellitus and hypertension. The haemogram and urine tests were normal. The only pathology revealed in routine biochemistry tests was increased glucose level (164 mg/dL). The repeat USG performed in our hospital revealed a solid hypoechoic mass lesion approximately 4 cm in diameter closely adjacent to the right kidney. At Doppler ultrasonography, the tumour demonstrated intense vascularisation. An abdominal CT scan was performed to characterise the lesion. The CT scan revealed a 42Ã-39 mm mass lesion with regular contours adjacent to the right kidney. In the arterial phase, the tumour demonstrated intense enhancement and in the delayed phase the images showed washout (figure 1). The patient underwent surgery and after histopathological examination retroperitoneal haemangiopericytoma was diagnosed and no relapse or distant organ metastasis was detected throughout the 2-year follow-up.

Gaucher's disease in a patient presenting with hip and abdominal pain.

Gaucher's disease is characterized by glucocerebroside accumulation in the cells of the reticuloendothelial system. There are three subtypes. The most common is type 1, known as the non-neuropathic form. Pancytopenia, hepatosplenomegaly and bone lesions occur as a result of glucocerebroside accumulation in the liver, lung, spleen and bone marrow in these patients. Findings associated with liver, spleen or bone involvement may be seen at radiological analysis. Improvement in extraskeletal system findings is seen with enzyme replacement therapy. Support therapy is added in patients developing infection, anemia or pain. We describe a case of hepatosplenomegaly, splenic infarction, splenic nodules and femur fracture determined at radiological imaging in a patient under monitoring due to Gaucher's disease.

The Relationship between Chondromalacia Patella, Medial Meniscal Tear and Medial Periarticular Bursitis in Patients with Osteoarthritis.

BACKGROUND: This study investigated the presence of bursitis in the medial compartment of the knee (pes anserine, semimembranosus-tibial collateral ligament, and medial collateral ligament bursa) in osteoarthritis, chondromalacia patella and medial meniscal tears. PATIENTS AND METHODS: Radiological findings of 100 patients undergoing magnetic resonance imaging with a preliminary diagnosis of knee pain were retrospectively evaluated by two radiologists. The first radiologist assessed all patients in terms of osteoarthritis, chondromalacia patella and medial meniscal tear. The second radiologist was blinded to these results and assessed the presence of bursitis in all patients. RESULTS: Mild osteoarthritis (grade I and II) was determined in 55 patients and severe osteoarthritis (grade III and IV) in 45 cases. At retropatellar cartilage evaluation, 25 patients were assessed as normal, while 29 patients were diagnosed with mild chondromalacia patella (grade I and II) and 46 with severe chondromalacia patella (grade III and IV). Medial meniscus tear was determined in 51 patients. Severe osteoarthritis and chondromalacia patella were positively correlated with meniscal tear (p < 0.001 and p = 0.018, respectively). Significant correlation was observed between medial meniscal tear and bursitis in the medial compartment (p = 0.038). Presence of medial periarticular bursitis was positively correlated with severity of osteoarthritis but exhibited no correlation with chondromalacia patella (p = 0.023 and p = 0.479, respectively). Evaluation of lateral compartment bursae revealed lateral collateral ligament bursitis in 2 patients and iliotibial bursitis in 5 patients. CONCLUSIONS: We observed a greater prevalence of bursitis in the medial compartment of the knee in patients with severe osteoarthritis and medial meniscus tear.