The popliteal artery is the most common site of peripheral aneurysmal formation. Arteriosclerosis, syphilis and mycotic infection are the most common etiological factors while in young adults, the aneurysm is often of the false type and caused by trauma. 1,2 Osteochondroma around the knee joint can give rise to such pathology that was first described by Brailsfords in 1953 3,4 followed by a more detailed account by Paul in the same year. 5Since that time, approximately 27 cases have been reported in the English literature, including ours. [6][7][8][9][10]16,[20][21][22] Case ReportA 23-year-old Saudi male was referred from another hospital with a history of severe pain and swelling in the right lower limb which occurred during jogging. The patient experienced difficulty in walking due to the pain and the decreased movement of the knee, but no pain at rest. There was a family history of hereditary multiple exostoses (HME).Physical examination showed diaphoretic skin, marked swelling of the right posterior lower extremity distal to the mid thigh primarily behind the knee. There was increased warmth and tenderness and palpable popliteal pulse. A thrill was reported early at the referring hospital, but disappeared after arrival at our hospital. All pedal pulses were palpable. The ankle/brachial pressure was 0.8. We recommended medical advice and treatment to the members of the family who were suffering from HME but the family refused. InvestigationPlain x-ray showed multiple osteochondroma over the left shoulder and left knee (Figure 1). Computed tomography (CT) and angiogram showed a false aneurysm at the popliteal artery with bony spikes originating from both femurs (Figures 2 and 3). This was performed in the referral hospital. Magnetic resonance imaging (MRI) performed at our hospital confirmed the presence of a large pseudoaneurysm which showed areas of decreased signal, signifying flow and a small area of hematoma seen medially (Figure 4).

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There had been an observed increase in the prevalence of depression as well as many chronic conditions of comorbidity among the elderly population of Ireland above the age of 50. The relationship between different prominent conditions of comorbidity and depression scores amongst older adult men in Ireland was sought to be examined and explored. MethodsA cross-sectional analysis of data from wave 1 of The Irish Longitudinal Study on Aging (TILDA) had been used for statistical analysis, which served to be the representative cohort study sample of elderly adults living in Ireland aged 50 and older. Summary statistics (cross-tabulation, t-test, analysis of variance/ANOVA and odds ratio) were used to explore the relationship between depression scores and different conditions of comorbidity. ResultsResults were drawn from the three different tests conducted; cross-tabulation, t-test, and analysis of variance/ANOVA. Cross-tabulation served to provide the total population of men who suffered from depression (CES-D score ≥ 16), which totaled 123 (1.4%) of the entire 8,504 available candidates. Of the participants that met the criteria for having a significant risk of clinical depression along with an accompanying chronic illness odds ratio (OR) had been calculated. All but one of the conditions yielded a significant increase in OR between having a chronic condition and depression; with the exception of chronic lung disease. Congestive heart failure demonstrated the highest OR of 4.40 (CI 95% 1.77-10.95), followed by arthritis, diabetes and cancer. Subsequent t-tests used to construct an ANOVA then illustrated the mean CES-D score for males suffering from one of the five concomitant illnesses selected (congestive heart failure, chronic lung disease, arthritis, cancer, and diabetes) as well as those free of the selected diseases of the study, with a total count of 2,117. All results had been deemed to be significant with p-values < 0.05, with men suffering from congestive heart failure having the highest mean score of 7.28 (n=39). Those who do not suffer from any of the five conditions reported the lowest scores and also accounted for the largest population group with 3.88 and 1,387, respectively. ConclusionsConsistent and significant findings of elderly men suffering from a chronic condition of comorbidity demonstrated having elevated OR and CES-D scores in comparison to those who are disease-free. The findings of this study can be used to evaluate alternative preventative management of chronic diseases of comorbidity in order to improve the depression scores of patients.