Objective: Evaluate incidence, etiology, and sonographic features of Baker's cyst in children. Materials and methods: We examined 16 pediatric patients, with the clinical diagnosis of Baker's cyst. The possibility to confirm or to exclude the presence of the lesion, assess the structure, presence of bilateralism and joint effusion were considered. Three subjects had known juvenile arthritis, 2 hemophilia, 11 a popliteal swelling in the absence of concomitant diseases. Results: In all patients it was possible to confirm (11) or to exclude (5) the presence of Baker's cyst. The idiopathic forms (6) exhibited anechoic structure; in patients with arthritis (3) there was hypertrophic synovium; in hemophilic patients at the presentation (2) anechoic structure with layering (serum and red blood cells); in chronic hemophilia synovial hypertrophy was seen. Joint effusion was constantly present in children with hemophilia and arthritis and in 1 case of idiopathic cyst. Conclusion: Baker's cysts in children are rare. Ultrasound is able to confirm or to exclude the presence of the lesion and it is able to evaluate characteristics, bilateralism and association with joint effusion.Sommario Obiettivi: Scopo del lavoro è valutare incidenza, eziologia e caratteristiche ecografiche delle cisti di Baker nei bambini. Materiali e metodi: Sono stati esaminati 16 pazienti di età pediatrica, con diagnosi clinica di cisti di Baker. È stata valutata la possibilità di confermare o di escludere la presenza di tale formazione, di documentarne la struttura, la presenza di bilateralità e di versamento articolare. Tra i pazienti esaminati 3 soggetti presentavano artrite reumatoide giovanile, 2 erano affetti da emofilia, 11 si presentavano con una tumefazione nel cavo popliteo, in assenza di patologie concomitanti. Risultati: In tutti i giovani pazienti è stato possibile confermare (11) o escludere (5) la presenza di cisti di Baker. Le forme idiopatiche (6) presentavano struttura oncogena, nei pazienti con artrite (3) mostravano ipertrofia della sinovia, in quelli emofilici (2), in fase iniziale, si osservava struttura anecogena con stratificazione (siero e globuli rossi), nelle forme croniche era presente ipertrofia sinoviale. Nei bambini con emofilia, artrite e in 1 caso di cisti idiopatica era presente versamento articolare. Conclusioni: Le cisti di Baker nei bambini sono rare. L'ecografia permette di confermare o di escludere la presenza di tali formazioni e di valutarne le caratteristiche, la bilateralità e la concomitante presenza di versamento articolare. ª

Congenital adrenal hyperplasia (also known as congenital adrenogenital syndromes) refers to a group of autosomal recessive diseases characterized by altered cortisol production, which may be associated with aldosterone deficiency. The absence of cortisol synthesis stimulates corticotropin production by the adrenal cells and the accumulation of cortisol precursors, which will be diverted for the production of sex hormones. In affected males, ectopic adrenal tissue frequently develops, usually at the testicular level. This tissue is absolutely identical to that of the adrenal gland itself, and its functionality can be stimulated by ACTH and suppressed with glucocorticoid therapy. The authors report the case of a male patient with classic congenital adrenal hyperplasia, who was referred to our staff for evaluation of bilateral testicular tenderness and enlargement. Color Doppler sonography revealed mild enlargement of both gonads, widespread disruption of the testicular echostructure, and hypervascularization. Two months later, when the underlying disease had been controlled, repeat color Doppler ultrasonography revealed markedly decreased vascularity, although no change was noted on the B-mode examination. The color Doppler findings thus represent an early indicator of response to treatment.

Iatrogenic injuries of the median nerve after surgical release for carpal tunnel syndrome resulting in the formation of a neuroma are rare. We present here the case of two patients, one with a bifid median nerve, showing in-continuity neuroma after surgical release for carpal tunnel syndrome. The patients reported persistent post-operative pain and showing symptoms. In both cases, ultrasound showed an in-continuity neuroma with a hypoechoic and enlarged median nerve at the carpal tunnel. The case report shows that ultrasound may be helpful in confirming the clinical diagnosis of neuroma and it is useful for evaluation of the percentage of the area affected by the tear.

No abstract

A 73-year-old male patient was transferred to our institution for endovascular treatment of mesenteric isch aemia. His chief complaint was loss of appetite, intense abdominal pain, described as cramps, vomiting associated with food or liquid intake and watery diarrhoea. Morphine was necessary for pain control. He lost 10 kg (from 74 to 64 kg) in 5 months. He denied melaena, h aematochezia or fever, and did not travel abroad. For several days before transfer he was unable to eat and a saline perfusion was started because even intake of fluids triggered abdominal pain and vomiting.