An 84-year-old female presented with a 2-day history of abdominal pain, vomiting, and constipation/obstipation. She had a prior history of abdomino-perineal resection for carcinoma of rectum 15 years ago. On examination, the abdomen was distended with increased bowel sounds. There was increased tenderness in the medial aspect of the thigh, no palpable inguinal mass, or any evidence of hernia. C...

Pulmonary hyalinising granulomas are rare, noninfectious fibrosclerosing lesions of the lung which can mimic metastatic disease. It was first described in literature by Engleman et al in the year 1977. Its etiology is unknown but they may be caused by an exaggerated immune response. The patient typically presents with cough, chest pain. dyspnoea or haemoptysis in association with multiple bilat...

A plain radiograph showed discrete areas of calcification around the cuboid and bases of his 4th and 5th metatarsals, with scalloping of the cuboid in keeping with a long standing pressure effect (fig. 1); these features were reported as being consistent with synovial chondromatosis. Magnetic resonance imaging (MRI) confirmed the diagnosis by revealing multiple foci of low signal intensity surr...

Tenosynovial chondromatosis is a very rare disease. The most common symptom is a slowly enlarging soft tissue mass, which may be painful or cause limitation of joint motion. Plain radiograph may appear normal during early phases of the disease, but subsequent imaging may be necessary to exclude other pathologies. Nonoperative treatment may be elected for some patients, but a synovectomy and the...

A 72-year-old diabetic male was referred by his general practitioner because of gradually increasing diarrhoea and abdominal pain over several days. On examination, he had mild acidotic breathing, and he appeared slightly dehydrated. The abdomen was distended and tender on palpation. Blood chemistry revealed slight derangement of his diabetes, and a neutrophil count of 12 x 10/l, liver enzymes ...

Early identification of the presence of stress fractures of the foot is often dependent upon clinical history and pattern of symptoms. The delay between presentation with symptoms and the confirmation of positive findings using plain film radiograph, or the invasive and more complex nature of bone scans or magnetic resonance imaging (MRI) can act as a deterrent to investigation. In contrast, th...

In patients with non specific acute low back pain, without the red flags, a conservative approach is preferable, with assessment in 4-6 weeks. The natural history of low back pain is favorable with improvement over time, thus reassurance to such patients is very important. However, a plain radiograph or more advanced imaging techniques like MRI/CT may be ordered in back pain associated with rad...

A 64-year-old man presented to our emergency room due to hematuria, lower abdominal fullness and urinary frequency for 2 days. The patient had a past history of diabetic nephropathy in chronic kidney disease, Stage 4, and benign prostate hypertrophy status posttransurethral resection of the prostate. Laboratory tests showed an elevation of the white blood cell count and C-reactive protein, acut...

We report a new case of a brucellar liver abscess (brucelloma) in a young woman without previous remote brucellosis who presented with pronounced systemic and mild local symptoms. Brucelloma is the result of calcification of a granoulomatous reaction induced by persistent Brucella in macrophages. It represents a rare manifestation that follows previously undetected brucellosis. We describe the ...

Pulmonary actinomycosis is a rare chronic pulmonary infection caused by actinomyces, a Gram-positive, microaerophilic bacterium. Pulmonary involvement other than cervicofacial or abdominopelvic actinomycosis is uncommon and often leads to a misdiagnosis of pulmonary tuberculosis or lung cancer. Endobronchial involvement is very rare in pulmonary actinomycosis. Here in, we describe the case of a...