It is uncommon in clinical practice to discover cancer as either a metastasis within soft tissue or containing heterotopic bone formation. These rarities are documented primarily through case reports in the literature. This report describes a patient with colon cancer whose painful wrist lesion was proven to exhibit both of these unusual features. It is important to...
(Vol 14 p 16-20, General Surgery; Orthopaedics; Pathology; Radiology: 3 September 2014)
Multiple pathologic fractures in a patient with sickle cell disease is rare; bone involvement is well documented in this disease, however multiple pathologic fractures as a complication are uncommon. We present a case involving a 19-month-old boy known to have sickle cell disease who developed multiple pathologic fractures as a complication of his disease. The patient was...
(Vol 13 p 63-68, Haematology; Orthopaedics; Paediatrics; Pathology; Radiology: 22 July 2013)
A case of a 27 year-old patient who presented after medical management of a missed miscarriage with an acute abdomen is described. She was found to have a haemorrhagic angiomyolipoma, which was successfully treated radiologically. This case highlights the need to consider this differential in the presentation of acute abdomen in the context of a recent or concurrent...
(Vol 12 p 44-48, General Surgery; Gynaecology; Radiology; Urology: 23 October 2012)
A 76-year-old man presented with a mass on his right leg. He had sustained an open fracture of the right tibia 58 years ago. Imaging showed a well-circumscribed fusiform calcified mass and atrophy of the right calf muscles. The findings and the history led to the diagnosis of calcific myonecrosis.
(Vol 12 p 10-13, Pathology; Radiology; Trauma: 5 March 2012)
We present the case of a healthy seasoned marathon runner who sustained bilateral quadriceps tendon rupture following a low-energy fall. Radiographs demonstrated bilateral patellar spurs. Our case report serves to highlight the importance of maintaining a high index of clinical suspicion in patients of all ages. This is the first report of bilateral quadriceps rupture in...
(Vol 11 p 77-80, Orthopaedics; Radiology: 4 November 2011)
Liposarcoma is a mesenchymal neoplasm of uncertain pathogenesis. It is the second most common soft tissue sarcoma, found uncommonly in the breast, and constitutes less than 1% of all malignant breast tumors. We report a case of a 50-year-old woman with a pleomorphic type liposarcoma of the breast.
(Vol 11 p 87-91, Breast surgery; General surgery; Oncology; Pathology; Radiology: 17 October 2011)
This is the case of a 7-year-old girl with a history of migraine headaches who presented with a head tilt to the left and worsening headaches. Papilloedema was found on ophthlamoscopy. She had an intermittent history of migraine-type headaches for the past year. Oral naproxen 375 mg twice daily provided some relief of the headaches initially but they slowly worsened and...
(Vol 11 p 81-86, Radiology; Oncology; Paediatrics: 17 October 2011)
Systemic amyloidosis secondary to myeloma is an uncommon condition that often has an insidious onset and poses as a diagnostic challenge due to the lack of typical presenting symptoms and signs. Prompt diagnosis of amyloidosis and appropriate referral have the potential to improve outcome for these patients. Here, we report the unusual case of a man whose primary...
(Vol 11 p 56-59, Haematology; Histopathology; Nephrology; Neurology; Pathology; Radiology: 18 July 2011)
A case describing a curious MRCP appearance is presented, which, placed in the clinical context, suggested an unusual tropical cause for the patient’s presentation and generated great debate between physicians, surgeons and radiologists.
(Vol 10 p 25-27, Gastroenterology; Radiology: 6 April 2010)
Radiation-induced sarcomas are a well-recognized late complication of radiation therapy. We present a rare case of a periosteal osteosarcoma of the femur developing 10 years after radiation treatment for a soft tissue sarcoma to highlight the clinical and radiological features of this rare complication of therapy and to describe its management.
(Vol 10 p 13-18, Orthopaedics; Radiology: 16 February 2010)
We report the diagnostic challenges raised by the uncommon synchronous finding of a lung sequestration and foregut cyst in a 76-year-old male scheduled for radical treatment of his colonic cancer. Following a computed tomography (CT) scan of the chest and a combined positron emission tomography (PET)-CT scan these lesions initially suggested a primary lung cancer with...
(Vol 9 p 45-48, Radiology, Thoracic surgery: 7 December 2009)
Lateral abdominal wall haematoma following blunt trauma can be a life-threatening condition and requires prompt diagnosis and treatment. We present the imaging findings and treatment modalities used for a young man presenting to the emergency department with abdominal pain and bruising.
(Vol 9 p 33-37, Accident and Emergency Medicine and Surgery (including Trauma), Radiology, Vascular Surgery: 17 November 2009)
Intramuscular supraspinatous cysts are rare and usually related to partial supraspinatous tendon tears. Conventional magnetic resonance imaging (MRI) and MRI arthrography are the most commonly used modalities for imaging such rotator cuff pathology. Treatment and follow-up of such cysts is not well documented in the literature. We report the successful conservative...
(Vol 9 p 29-32, Orthopaedic surgery, Radiology: 17 November 2009)
Intestinal obstruction secondary to displacement of a stone from the gall bladder into the intestinal tract is relatively uncommon. The commonest site of calculus impaction is at the ilio-caecal valve. Occasionally, however, the gall stone may either pass through the valve into the colon or perforate directly into the transverse colon and impact in the distal colon. The...
(Vol 9 p 9-13, Radiology: 29 April 2009)
Postpartum cardiomyopathy (PPCM) is the development of heart failure in the last month of pregnancy or within 5 months after delivery without an identifiable cause in a previously healthy female. It is a rare condition, which carries a high maternal mortality. We describe the case of a 35-year-old South Asian woman who presented with dyspnoea, fatiguability, peripheral...
(Vol 8 p 19-21, Cardiac Imaging; Cardiology: 26 June 2008)
A 60-year-old woman attended A&E following an unwitnessed ‘collapse query cause’. Over 4 months she recalled involuntary movement of her eyes and head to the left and, on one occasion, complete rotation of her body. She had subtle neurological signs. Imaging identified the cause of these adversive seizures.
(Vol 7 p 61-63, Accident and Emergency Medicine and Surgery (including Trauma); Neurology; Neuroradiology; Neurosurgery: 13 June 2007)
Penetrating injuries with retained foreign bodies are a frequent cause of synovitis affecting the extremities. The management of plant thorn synovitis raises a number of diagnostic and treatment challenges.
(Vol 7 p 16-17, Rheumatology, Radiology: 20 February 2007)
We report a case of persistent haemoptysis, initially investigated by chest physicians. An Ear, Nose and Throat (ENT) opinion was sought because no source for the bleeding could be found. On video-endoscopic examination of the trachea using a three chip digital camera system, a vascular lesion, possibly an arteriovenous malformation, was seen on the anterior tracheal wall...
(Vol 6 p 25-27, Radiology, Respiratory medicine: 21 September 2006)
Centripetal enhancement of liver lesions on MRI scanning is an almost specific finding in the diagnosis of benign hemangiomata. The ability of MRI to produce higher temporal resolution of dynamic measurements shows that malignant liver lesions can also demonstrate centripetal enhancement. We report here a case of a malignant gastrointestinal stromal tumor (GIST) with a...
(Vol 3 p 8-12, Oncology and Radiology: June 2003)
Critical ischaemia of the lower limb secondary to occlusion of the puncture site vessel is an unusual but well-recognized complication of endovascular intervention. We present two patients who developed such a complication. In each case, the initial treatment plan was to perform an emergency thrombectomy. However, both cases were found to resolve dramatically with the...
(Vol 2 p 1-3, Vascular Radiology: April 2002)
False aneurysms of the axillary artery are rare complications of blunt trauma and dislocation of the shoulder. We present a case of false aneurysm of the axillary artery secondary to traumatic fracture of the humeral neck, which resulted in brachial plexus damage and was initially diagnosed as a neoplasm.
(Vol 2 p 4-7, Vascular Radiology: January 2002)


Frank Cross
Consultant Vascular and General Surgeon
The London Clinic, UK


Neil Barnes
Consultant Physician
Barts Health NHS Trust, London, UK
Ali Jawad
Professor of Rheumatology
Barts Health NHS Trust, London, UK

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