Extraction of incarcerated medial epicondyle from the elbow joint using conventional nerve stimulator:a case report

INTRODUCTION: Incarceration of the medial epicondyle is a well-recognised sequelae following closed reduction of the elbow. Manipulation for extraction is not usually successful and hence an incarcerated medial epicondyle is usually an indication for open reduction and fixation. CASE PRESENTATION: We describe a simple technique of closed reduction using a conventional nerve stimulator to extract an incarcerated medial epicondyle in a 13-year-old Caucasian boy. This technique uses contraction of the attached common flexor muscles to indirectly extract the trapped medial epicondyle. CONCLUSIONS: This is a simple technique using a commonly available nerve stimulator and may obviate the need for extensile open reduction for extraction of the incarcerated medial epicondyle. We would recommend this technique where closed reduction methods have failed

Extra-osseous osteochondroma-like soft tissue mass of the patello-femoral space

BACKGROUND: Extraskeletal cartilaginous tumors are uncommon. Osteochondromas usually arise from the metaphyseal region of the growing skeleton. CASE PRESENTATION: A 53 year old man presented with a three years history of anterior knee pain and inability to flex his knee more than 90°. Clinical examination and imaging studies revealed a nodular calcific mass in the anterior portion of the knee, displacing the medial portion of the patellar tendon. Following excision, histopathology confirmed the diagnosis of extra-osseous osteochondroma-like soft tissue mass, with no recurrence 24 months after surgery. CONCLUSION: An integrated clinical-pathologic diagnosis helps to clarify the nature of extraskeletal cartilaginous tumors that can arise at unusual anatomic site. Complete local surgical excision is the management of choice

The Radiopharmaceutical Chemistry of Fluorine-18: Nucleophilic Fluorinations

The positron-emitting radionuclide fluorine-18 plays a prominent role in radiopharmaceuticals for positron emission tomography (PET) due to its favourable nuclear decay properties. Depending on the production method, 18F can be obtained in two different chemical forms: electrophilic [18F]fluorine gas and nucleophilic [18F]fluoride. Nucleophilic [18F]fluoride exhibits several advantages with respect to accessibility and chemical handling. Therefore, nucleophilic 18F-substitution reactions are of pivotal importance for the production of PET radiotracers. This chapter is devoted to this class of reactions, and in the following pages, we seek to provide a general overview of 18F itself as well as insights into nucleophilic 18F-substitution reactions. More specifically, the prerequisites for this reaction with regard to solvent, leaving groups, reactants, etc. are examined. Furthermore, several examples are discussed which demonstrate the potential of this reaction to create highly clinical relevant PET tracers. Finally, this chapter also provides practical tips and tricks for those performing this reaction in the laboratory