Uncommon cause for anterior knee pain - Aggressive aneurysmal bone cyst of the patella

A 56-year-old man presented with a two month history of increasing anterior knee pain without previous trauma. As usual we recommended physiotherapy with stretching exercises of the quadriceps muscle. Since symptoms did not improve after 6 weeks MRI was performed. Surprisingly a hyperintense lobulated mass of the patella with small fluid-filled cavities at the inferior pole was revealed. We performed an open biopsy to exclude any malignancy and diagnosed an aneurysmal bone cyst. Further examination with CT scans showed an aggressive behaviour with cortical breakthrough

Sepsis: in search of cure

Introduction Sepsis is a complex inflammatory disorder believed to originate from an infection by any types of microbes and/or their products. It is the leading cause of death in intensive care units (ICUs) throughout the globe.The mortality rates depend both on the severity of infection and the host’s response to infection.Methods Literature survey on pathobiology of sepsis in general and failure of more than hundred clinical trialsconducted so far in search of a possible cure for sepsisresulted in the preparation of this manuscript.FindingsSepsis lacks a suitable animal model thatmimics human sepsis. However, based on the resultsobtained in animal models of sepsis, clinical trials con-ducted so far have been disappointing. Althoughinvolvement of multiple mediators and pathways in sepsishas been recognized, only few components are being tar-geted and this could be the major reason behind the failureof clinical trials.ConclusionInability to recognize a single critical medi-ator of sepsis may be the underlying cause for the poortherapeutic intervention of sepsis. Therefore, sepsis is stillconsidered as a disease—in search of cu