SUMMARY Two more cases of B27 associated peripheral arthritis triggered by physical injury are reported. One patient developed arthritis after a minor insult and in the other Reiter's syndrome occurred after the injury. Possibly, trauma causes release of self antigens from the injured joints.
Three more cases of B27-positive patients who developed peripheral arthritis immediately after trauma are reported. The first had an exacerbation of arthritis in the right hip after falling from her motor-bike. The second had arthritis of the distal interphalangeal (DIP) joint of the right forefinger after shutting his finger in the door of his car. The third had arthritis of the right sternoclavicular joint after a road-accident while fastening her safety belt.
Background: Pneumomastia is air within the breast parenchyma. A number of causes have been reported for this condition. This case report describes a new cause and details of the management strategy applied, together with a review of the literature. Case Report: We describe a case of acute breast swelling in a 40-year-old woman and its subsequent successful conservative management. Conclusion: Bronchopleural fistula after thoracotomy is a risk, and can cause pneumomastia. This is more likely to occur after redo thoracic surgery. Pneumomastia after repeat thoracotomy can be managed conservatively, even in the presence of a bronchopleural fistula.
We present what maybe the only case of splenic infarction causing hyperamylasaemia in a patient with bacterial endocarditis. A 49-year-old gentleman presented a 24 hour history of vomiting, abdominal pain and fever. Clinical examination showed diffuse upper abdominal tenderness, a mild tachycardia and a low grade pyrexia. Blood investigations showed a hyperamylasaemia. His failure to improve on treatment for a provisional diagnosis of alcohol induced pancreatitis lead to a CT abdomen, which showed a splenic infarct and an echo showing aortic valve vegetation's as a source of emboli. He underwent urgent aortic valve replacement with a tissue valve following which he made an uncomplicated recovery.
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