Bone metastasis as the first sign of gastric cancer

The skeleton is a common metastatic site for visceral carcinomas. However, the presentation of gastric cancer as bony metastases without preceding gastrointestinal symptoms is rare which has been infrequently reported in the literature. We report an infrequent case of a 60-year-old patient diagnosed having a gastric carcinoma with bone metastasis as the first evidence. She has consulted with worsening backache which started two months priorly

Reparative radiological changes of hip joint after TNF inhibitors in ankylosing spondylitis

Background: Hip involvement in ankylosing spondylitis (AS) is a common extraspinal arthritic manifestation, which is associated to a worse functional outcome. Little data are available on the effectiveness of conservative treatment strategies. The TNF inhibitors have been proven effective on AS activity parameters. Their structural effect on hip disease however, little is studied. Case presentation: We describe four new cases of reparative changes of a damaged hip joint after treatment with TNF inhibitors. The average of age was 32.5 (27- 36) years. There were 3 men and 1 woman. Hip involvement was bilateral in all cases. Etanercept was prescribed in 3 cases and infliximab in 1 case. At baseline, all patients had a painful and limited hip with high disease activity and an important functional impairment. After an average of 5.5 years of treatment with TNF inhibitors, the BASRI hip evaluated in antero-posterior x-rays of the pelvis remained unchanged at 2.4. The average of mean hip joint space was 2.9mm (2.3-3.6). A widening in hip joint space was observed in all cases with less subchondral cysts. Conclusion: TNF inhibitors seem to be effective on hip joint disease in patients with AS

Painful bruising syndrome: A case report

Painful bruising syndrome or Gardner-Diamond syndrome is characterized by an auto erythrocyte sensitization syndrome. We report, here a new case of painful bruising syndrome in a woman with no psychiatric disorders. A 29-year-old female patient presented with complaints of painful bruising over the lower extremities of three years duration. She had a personal history of a severe rheumatoid arthritis. Dermatological examination revealed multiple erythematous, nonedematous and ecchymotic macules over the legs. A psychiatric examination was normal. Complete blood count, prothrombin time and liver function tests were normal. Intracutaneous sensitivity test confirmed Painful bruising syndrome