Telemedical technologies provide significant benefits in sports for performance monitoring and early recognition of many medical issues, especially when sports are practised outside a regulated playing field, where participants are exposed to rapidly changing environmental conditions or specialised medical assistance is unavailable. We provide a review of the medical literature on the use of telemedicine in adventure and extreme sports. Out of 2715 unique sport citations from 4 scientific databases 16 papers met the criteria, which included all research papers exploring the use of telemedicine for monitoring performance and health status in extreme environments. Their quality was assessed by a double-anonymised review with a specifically designed four-item scoring system. Telemedicine was used in high-mountain sports (37.5%; n = 6), winter sports (18.7%; n = 3), water sports (25%; n = 4), and long-distance land sports (18.7%; n = 3). Telemedicine was used for data transfer, teleconsulting, and the execution of remote-controlled procedures, including imaging diagnostics. Telemedical technologies were also used to diagnose and treat sport-related and environmentally impacted injuries, including emergencies in three extreme conditions: high mountains, ultraendurance activities, and in/under the water. By highlighting sport-specific movement patterns or physiological and pathological responses in extreme climatic conditions and environments, telemedicine may result in better preparation and development of strategies for an in-depth understanding of the stress of the metabolic, cardiorespiratory, biomechanical, or neuromuscular system, potentially resulting in performance improvement and injury prevention.

Papillary thyroid carcinoma (PTC) is the most common form of thyroid tumour in childhood. Different studies reported higher risk of developing a PTC in Hashimoto’s thyroiditis patients (HT) even in paediatric-adolescent age, although real incidence and risk factors are unknown. The paper describes the case of a girl, diagnosed with HT and hypothyroidism at the age of 11, who developed thyroid ultrasound alterations after two years. The histological examination of the satellite lymph node confirmed the diagnosis of PTC. A total thyroidectomy was performed. The follow up scintigraphy did not show disease residues, so no indication was given to radioiodine therapy. The case report underlines the importance of an accurate thyroid and lymph nodes ultrasound monitoring in children with autoimmune thyroiditis, in order to highlight possible malignancy development.

Hematocolpos is a term given to a blood-filled dilated vagina due to menstrual blood. When there is concurrent uterine distention, the term hematometrocolpos is used. These conditions are mostly in the setting of an anatomical obstruction, usually an imperforate hymen. Usually, clinical presentation may be characterized by primary amenhorrea, recurrent abdominal or pelvic pain, urinary retention and dys-uria or constipation. Imaging techniques such as trans-abdominal ultrasound and nuclear magnetic res-onance are respectively the exam of choice and the “gold standard” exam for diagnosing hematocolpos. The paper reports the case of a 12-year-old girl with a sacral pain present for a month, not associated with other symptoms with a diagnosis of hematocolpos that became evident to the magnetic resonance.