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Photoplethysmography was compared with clinical investigation combined with Doppler ultrasonography in the diagnosis of superficial venous valvular incompetence of the lower limb. In 268 consecutive patients, 536 limbs were investigated. A total of 22.1 per cent of the photoplethysmographic investigations were uninterpretable because they did not allow reliable determination of the refilling time. Agreement between clinical investigation combined with Doppler ultrasonography and photoplethysmography was found to be poor (kappa = 0.30). These results suggest that photoplethysmography is not the non-invasive method of choice for routine evaluation of superficial venous valvular incompetence of the leg.

Four cases are described of acute non-traumatic rhabdomyolysis with subsequent development of a compartmental syndrome, requiring extensive fasciotomies. All the patients were young male alcoholics who were taking benzodiazepines as part of an addiction treatment programme. In this risk group clinicians should be aware of two serious complications of non-traumatic rhabdomyolysis: acute renal failure and compartmental syndrome.

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In a patient who had received presurgical radiation therapy for extensive rectal carcinoma, ultrasonography with graded compression disclosed an inflamed appendix. The patient had no clinical signs of acute appendicitis. At laparotomy for resection of the rectal carcinoma, the appendix appeared grossly abnormal and was removed. Pathologic examination showed severe radiation enteritis of the appendix. The sonographic appearance of radiation appendicitis closely resembled that of acute appendicitis.