An isolated fat pad sign (i.e. joint effusion without a visible fracture), commonly seen in acute elbow injury, is associated with occult fracture and treated as such. However, the clinical relevance of an isolated fat pad is unclear, thereby questioning the need for specialized follow-up. In this study, 111 patients (median age 15 years, interquartile range 9-27 years) with an isolated fat pad...

Operative management of unstable burst vertebral fractures is challenging and debatable. This study of such cases was conducted at the Aga Khan Hospital, Karachi from January 1998 to April 2003. All surgically managed spine injuries were reviewed from case notes and operative records. Clinical outcome was assessed by Hanover spine score and correction of kyphosis was measured for radiological a...

in this paper, we discuss the present situation of laparoscopy in gynecology. there is no doubt that hospital stay, postoperative pain and convalescence are less when it is possible to treat gynecologic disease via laparoscopy. however, for reaching the final conclusion about the other effects of this kind of surgery, e.g., adhesion formation after operation, pregnancy rate, etc., a series of p...

The development of persistent post-operative pain after implant placement for aesthetic or reconstructive breast surgery can lead to significant patient morbidity. Although there are many etiologies for post-operative pain, the diagnosis of an intercostal neuroma is important as this can be treated surgically. We describe three cases of an intercostal neuroma in patients with breast implants. A...

OBJECTIVE The aim of this study was to evaluate the reconstruction of the medial patellofemoral ligament associated with the medial patellotibial ligament in skeletally immature patients. METHOD This is a case series study in patients with patellar instability with open physis. In total, seven patients were evaluated: four males and three females were operated using the proposed technique. Pa...

Ultrasound techniques currently employed in the definition of posterior compartment deep infiltrating endometriosis (DIE) are now well described. These include the sonovaginography, first described by Dessole in 2003, for mapping the location and extent of posterior compartment DIE and more recently the real time dynamic ‘sliding sign’ for the assessment of the status of the Pouch of Douglas (P...

This brief report is about a 9 year old girl presenting with a 2.5 cm circular blue to violet discoloration on the anterolateral upper left thigh. The first biopsy taken revealed the diagnosis dermatofibrosarcoma protuberans. The patient underwent surgery at a specialized sarcoma center with post operative histology showing free wide resection margin. Preoperative chest x-ray showed no sign of ...

This case presentation highlights important principles in the management of post-traumatic diaphragmatic hernia. A suggestive history should prompt early diagnosis even if the patient appears well. The chest radiograph, although not pathognomonic, is extremely useful in the detection of diaphragmatic hernia if accurately interpreted. Herniated bowel is at high risk of strangulation, especially ...

Gastric pneumatosis is a radiographic finding that represents a spectrum of conditions ranging from benign disease to abdominal sepsis and death. Along with portal venous gas, it is generally considered an ominous sign prompting emergent operative intervention. We report a rare case showing that diagnostic laparoscopy can be used to confirm or refute full thickness ischemic necrosis and that co...