Introduction This case report presents a rare case of vertebral artery and spinal cord injury due to air rifle pellet. Case presentation A previously healthy 19-year-old male was shot on his left neck incidentally during recreational air rifle game. He was taken to the other hospital before being referred to our hospital. Clinical findings and investigations The patient presented with total loss of motoric function on his left side of the body together with sensoric function on the contralateral side from the level of C5 and below. Signs of stroke were also spotted on the patient's face. The cervical plain radiograph and CT scan were carried out preoperatively to depict pellet fragments. Meanwhile, the CT angiography which was commenced postoperatively revealed the left vertebral artery injury. Interventions Surgery comprising of pellet fragments removal, decompression and posterior stabilization of the cervical spine was carried out to retrieve the pellet fragments, which were embedded at the posterior epidural space. Relevance and impact Our findings were consistent with the vertebral artery injury and Brown-Sequard syndrome. Hence, these clinical entities should be considered in the setting of penetrating cervical trauma.

Introduction: Posterior tibial tendon dysfunction is one of the most common, problems of the foot and ankle. Tenosynovitis of the posterior tibial tendon (PTT) is an often unrecognized form of PTT dysfunction. Case: A 54-year-old woman presented with left ankle pain that began while morning walk three days prior. She noted that the left ankle hurt with even light touch and the pain was unrelieved with sodium diclofenac. She denied any history of trauma. She was seen in the outpatient clinic for this condition. On examination, a three centimeter area of pain was found posterior to the medial malleolus and parallel to the PTT. She also had a stage I flat foot and mild soft tissue swelling around medial malleolus region on her radiograph examination. Ultrasound examination was done with the result of anechoic fluid visible in the peritendinous space around the PTT. The patient received diagnosis of PTT tenosynovitis, with the foot and ankle disability index (FADI) score was 58.7. Platelet rich plasma (PRP) injection was done twice with an interlude of two weeks. The pain subsided and the following FADI score was 84.6. Outcome: Patient showed improvement in her left ankle PTT tenosynovitis after two PRP injection. Conclusion: This case report highlights the efficacy of PRP as a modality in managing PTT tenosynovitis.