Introduction. Lung cancer often gives metastases in the bone system, of which the wrist accounts for 0.1% and the bones of the wrist are primarily affected in only 17% of cases. We presented a patient with the delayed diagnosis and a rare localization of isolated metastases of lung cancer to carpal bones which ended with upper arm amputation. Case report. A 56-year-old, a laborer, healthy, smoker, coughing for decades with occasional expectoration, hoarseness, during the last 3 months felt pain in his right wrist. He denied trauma. Physical examination led to the diagnosis of tendovaginitis of the hand. He visited a physiatrist and began treatment. After the therapy, symptoms were partially decreased and later began to worsen with symptoms of the median nerve compression. The neurologist diagnosed it as the carpal tunnel syndrome. The patient's condition worsened and he was sent to the Emergency Center of the Clinical Center of Vojvodina, Novi Sad, Serbia with the diagnosis of arthritis of the wrist. The final diagnosis of lung adenocarcinoma with isolated metastasis to bone tissue was made with a biopsy of the tumor and examination by an oncologist. Primary tumor localization was diagnosed with a computed tomography (CT) scan and skeletal scintigraphy. The patient underwent upper arm amputation and was sent to an oncologist. Conclusion. Carefully taken anamnesis, detailed general and local examination, and frequent monitoring of patients could help make a correct diagnosis of this rare localization of the lung cancer, before the spreading process and the occurrence of severe complications.

In order to improve survival of patients with out-of-hospital CA, both education of laymen and introduction of standard questioning protocol in the IEMS Call Centre are necessary.

Background/Aim. Anterior cruciate ligament reconstruction is one of the most commonly performed knee surgeries in the younger population. The success of this procedure largely depends on the proper formation of the tunnel, which is obtained by drilling the tibia and which serves to position and fix the graft. Methods. The study was performed on a group of 15 patients in whom the developed software applied the measurement of the angle of the tunnel in the tibia based on the selection of characteristic points on two standard X-rays of the knee (anterior-posterior and lateral projection). The obtained results were compared with the results of measuring the angle of the tunnel in the tibia on knee images by computed tomography (CT) in all patients. Results. The drilling angle measured in CT scans is on average somewhat greater 59.07 ? 5.61? than the angle measured by applying a developed application 58.65 ? 5.89?. The obtained results indicate minimal differences without statistical significance in the measurements of the angle of the tunnel in the tibia using the developed software and on CT images (Wilcoxon test: Z= -1.363; p=0.173). Conclusion. The analysis of the obtained results concludes that the presented method and developed software are suitable for everyday clinical application from the population of precision and usability and can be used to assess the position of tunnels in the tibia in the process of determining the success of surgery or in preparing patients for revision surgery.