A retrospective analysis was made of the radiologic features of 30 cases of mycetoma. Conventional radiographs, computerized tomography (CT), and isotope bone scans were assessed. Soft-tissue swelling was the only abnormality in 27%. Periosteal reaction was present in 67%, sclerosis in 53%, endosteal reaction in 50%, and cortical erosions in 43%. Cavities which were found in 33% are important as predictors of the causative micro-organism. Conventional radiographs are essential to the management of mycetoma as bone involvement makes non-surgical cure unlikely. The role of CT in diagnosis and management appears to be minor, except when the thigh is involved. Isotope bone scanning appears to have no value in either diagnosis or management.

The case histories of three adult patients are presented. Malignant disease was present in all three. During the course of investigation and treatment one patient was found to have a lymphoma, another to have polymorphic reticulosis and the third had been under treatment for chronic myeloid leukaemia. The possible aetiological factors responsible for this clinical syndrome are discussed.

The office procedure of creating tunnel grafts for attachment of hairpieces is not without complications. Early complications such as a hematoma under a graft, bacterial infection, and maceration of the epithelium lining the tunnels tended to be acute, but minor. Late complications, such as cutting in of the clips into the roofs of tunnels or stretching of the tunnel-graft roof, were mainly of a mechanical nature. Recommendations for reducing the indicence of such complications are made.

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