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A rare case is presented of acute anterior compartment syndrome in the thigh of a footballer caused by an acute quadriceps strain, exacerbated by poor first aid and alcohol ingestion. Decompressive fasciotomy with subsequent split skin grafting of the wound defect resulted in a satisfactory outcome. The diagnosis requires a high index of suspicion lest it be overlooked with inevitably disastrous consequences.

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Summary. Surgical resection is the only definitive treatment for haemophilic pseudotumour. For patients with highresponding factor (F)VIII inhibitors, the lack of reliable by-passing agents in the past has meant that surgery has been avoided in favour of conservative measures. The development of recombinant factor VIIa (rFVIIa) has revolutionized the management of surgery in these patients. We document the first successful report of the surgical resection of a massive pseudotumour in a patient with high responding FVIII inhibitors using rFVIIa to achieve haemostasis. Serial post-operative measurements indicated that FVII coagulation activity (FVII:C) levels were more sensitive to rFVIIa dose changes than the prothrombin time.

Shrinking lung syndrome (SLS) is a rare manifestation of systemic lupus erythematosus, characterized by progressive dsypnoea, reduced lung volumes and associated restrictive lung physiology. Here, we provide two previously unreported cases, and review the available literature on the pathophysiology, clinical features and management of SLS. Effective treatment can prevent further deterioration or lead to improvement in abnormal lung function. A heightened awareness of SLS and its management is therefore required to prevent disease progression and increased morbidity.