Appearance of osteolysis with melorheostosis: redefining the disease or a new disorder? A novel case report with multimodality imaging.

We present a case report of melorheostosis with the novel radiographic finding of underlying cortical resorption. A number of radiographic patterns of melorheostosis have been described; however, the combination of new bone formation and resorption of the original cortex appears unique. Although the presence of underlying lysis has been postulated in published studies, direct radiographic evidence of bony resorption in melorheostosis has not been reported. These findings can be subtle and might go unnoticed using standard imaging. An in-depth review of the radiographic features is presented, including multimodality imaging with magnetic resonance imaging and computed tomography.

The ABC's of wound care.

Non-healing wounds represent a challenging problem for physicians and patients alike. Although treatment strategies are aimed at specific causes, there are basic management principles that apply to all wounds. The purpose of this article is to review these core management principles as they apply to lower extremity wounds. Key points include a multidisciplinary approach and individualized plans of care as per specific patient needs. A comprehensive treatment plan will lead to faster healing and improved outcomes.

The nutcracker syndrome.

Left renal vein (LRV) compression, commonly referred to as the nutcracker syndrome or renal vein entrapment syndrome, is a rare and often overlooked condition. Anatomically, the LRV traverses the space between the superior mesenteric artery and the aorta in close proximity to the origin of the artery. In affected individuals, the LRV is subjected to compression between these two structures, resulting in renal venous hypertension. A review of published data on this condition reveals either case reports or small case series. The classic symptoms of nutcracker syndrome include left flank pain with gross or microscopic hematuria. Patients are often children or young adults, with a slight predisposition for women who may also present with pelvic congestion symptoms such as pelvic pain and dyspareunia. Most patients have disease symptoms for many years and nondiagnostic investigations before proper diagnosis can be made. Appropriate diagnostic work-up and treatment may help alleviate patient morbidity from this chronic condition. Although surgical repair has been the standard of care, more recently endovascular intervention has become the first line of therapy. This tabular review compiles published cases in the adult population during the period between 1980 and 2009.