The results indicate that weightbearing, multiplanar imaging provides a reliable means of assessing lateral pain in patients with flexible flatfoot deformity.

Primary bone lymphoma (PBL) is rare bone disease that accounts for very small number of all primary bone tumors. Among the described sites of PBLs, the patella is an extremely rare example. To date, only a few cases of PBL affecting the patella have been reported. Clinically, these tumors have very similar presentation of pain, decreased range of motion and swelling and, sometimes, pathologic fractures. On radiographs, skeletal lymphoma commonly manifests as osteolytic lesions with ill-defined margins affecting the metaphysis of axial long bones. We present a rare case of patellar adult T-cell lymphoma/leukemia in a 58-year-old female who presented with left-knee pain and swelling. Computed tomography and magnetic resonance imaging revealed diffuse marrow replacement by a lesion with aggressive features. PET scan demonstrated neoplastic range hypermetabolic FDG uptake within this lesion. Ultrasound-guided biopsy was consistent with PBL.

Thyroid acropachy is a rare complication of autoimmune thyroid disease with characteristic imaging findings. Clinically, it presents as nail clubbing, swelling of digits and toes, almost always in association with thyroid ophthalmopathy and dermopathy. On radiographs, it manifests as prominent irregular and spiculated periosteal new bone formation in the hands and feet. We present a 52-year-old man with history of Graves’ disease who presented with swelling of the hands and feet. Radiographs of the hands and feet revealed marked diffuse soft tissue edema and characteristic periosteal new bone formation most consistent with thyroid acropachy.

Intramedullary nailing is an accepted treatment for the fixation of femoral and tibial shaft fractures. There is a low but significant incidence of intraoperative complications during intramedullary nailing. During this procedure, a medullary tube may be used to exchange the bent olive-tipped reaming guidewire for the straight guidewire. A review of the literature found only one report of a fracture of the medullary tube. Two cases in which the medullary tube fractured into multiple pieces are presented.