Background/Objectives: This aim of this study was to describe the demographic, clinical, and laboratory characteristics of hospitalized children with benign acute childhood myositis (BACM) and to evaluate seasonal patterns, including changes observed during the COVID-19 pandemic. Methods: We conducted a retrospective single-center review of pediatric patients hospitalized with a diagnosis of BACM between January 2016 and December 2024. Clinical, laboratory, and epidemiological data were analyzed, including seasonal distribution before and after the COVID-19 pandemic. Results: We identified 47 cases of BACM, with a male predominance (66%) and a median age of 7 years. Most cases (72%) occurred during autumn and spring. The most common prodromal symptoms were fever, cough and rhinorrhea. Bilateral calf pain was the most frequent presenting symptom. The median creatine phosphokinase (CPK) level was 4986 U/L, with higher values in boys (p = 0.040). Higher CPK levels were associated with longer hospital stays in our cohort (p = 0.030). Influenza B was the most frequently identified pathogen (63%). No BACM cases were recorded during the COVID-19 pandemic period (2020-2022), followed by an increase in 2024. All patients fully recovered, with a median hospital stay of 3.2 days. Conclusions: BACM is a self-limiting condition with a characteristic clinical and laboratory profile. The absence of cases during the COVID-19 pandemic suggests a possible association between reduced viral circulation and BACM incidence. Awareness of its typical presentation may support early diagnosis, reduce unnecessary investigations, and facilitate appropriate clinical management.

The management of recurrent venous thromboembolism requires a high index of suspicion for underlying structural anomalies such as May-Thurner syndrome (MTS). Although the prothrombotic consequences of venous compression are well established, its influence on embolization dynamics has not been clearly defined. We report the case of a 38-year-old female with recurrent left-sided iliofemoral deep vein thrombosis (DVT) who presented with progressive calf pain without cardiopulmonary symptoms. Venous Doppler ultrasound demonstrated extensive thrombosis of the iliac, femoral, popliteal, and tibial veins. Pulmonary computed tomography angiography (CTA) revealed a clinically silent distal pulmonary embolism (PE). Abdominal CTA, using a triple-phase acquisition protocol, showed an 80% diameter stenosis of the left common iliac vein due to compression by the right common iliac artery, consistent with MTS. Thrombophilia testing was negative. The patient was treated successfully with oral anticoagulation and graduated compression stockings (GCS) as she declined endovascular stenting. This case confirms the established association between MTS and recurrent left-sided thrombosis. It also raises the theoretical possibility that severe iliac vein stenosis could modulate embolus size through altered venous flow dynamics. However, this hypothesis remains speculative and requires confirmation in mechanistic and epidemiologic studies.

Tennis leg is a common cause of acute posteromedial calf pain and encompasses a spectrum of injuries involving the posterior calf. Although initially described as rupture of the plantaris tendon, clinical, surgical, and imaging evidence indicates that injury to the medial head of the gastrocnemius at the distal myotendinous junction is the most frequent cause. Less commonly, the lateral gastrocnemius, the soleus, or the plantaris may be affected. Clinical presentation is often nonspecific and overlaps with important alternative diagnoses, including Achilles tendon rupture, deep vein thrombosis, and ruptured Baker cyst, making imaging helpful for accurate diagnosis. Sonography (US) and magnetic resonance imaging (MRI) are the principal imaging modalities used in assessment. US is well suited for initial evaluation due to its wide availability, dynamic capability, and high spatial resolution for superficial tissues. It enables panoramic assessment of the posterior calf, allowing detection of muscle fiber disruption, myoaponeurotic injury, and intermuscular hematoma, while also facilitating exclusion of common mimics. MRI provides superior characterization of deep or subtle myoconnective tissue injuries and allows comprehensive assessment of injury extent and associated findings. In addition, MRI supports standardized grading using established muscle injury classification systems, which is valuable for prognosis and return-to-play decision-making. Emerging imaging techniques like quantitative MRI and artificial intelligence-based analysis may improve injury prognostication and individualized return-to-play assessment. This review summarizes the relevant anatomy, definitions, mechanisms of injury, and characteristic US and MRI features of tennis leg. Current classification systems are outlined, and key differential diagnoses and potential complications are also discussed.

Background: Currently, the duration of tourniquet time in total knee arthroplasty is chosen by the surgeons and varies between 0 and 120 min. Studies evaluating the effect of tourniquet time in this surgery are heterogeneous, and there is limited information on molecular/complement profiling. The purpose of this study was, therefore, to determine whether the duration of tourniquet-induced limb ischemia during total knee arthroplasty influences reperfusion injury, resulting in pain, swelling, and the release of pro-inflammatory markers. Methods: In 40 patients undergoing total knee arthroplasty, a tourniquet was applied for up to 30 min (group A, short tourniquet) or 90-120 min (group B, long tourniquet). Postoperative pain and swelling served as primary outcome parameters. The levels of pro- and anti-inflammatory markers before surgery and 4 h, 24 h, and 48 h after surgery were used as secondary outcome parameters for exploratory testing. Results: There were no differences in numeric rating pain scale (NRS) scores and calf circumference between groups A and B. Patients in group B required patient-controlled intravenous analgesia more frequently than group A patients (47% versus 5%, group B vs. group A, p < 0.0001). In group B, a significantly higher increase in C3a and MIG levels between 4 h and 48 h, and a significantly higher increase for MIG and M-CSF between 24 h and 48 h, were observed. Conclusions: Tourniquet times between 90 and 120 min were not associated with higher pain levels or more swelling, but an increased need for intravenous analgesia and a higher increase in pro-inflammatory markers. This might be a consequence of a more pronounced ischemia/reperfusion injury with tourniquet times longer than 90 min.

Acute compartment syndrome (ACS) is a surgical emergency most commonly associated with trauma. A less common variant, acute exercise-induced compartment syndrome (AEICS), occurs without direct injury and is rarely seen in strength athletes. We report a case of a 50-year-old male powerlifter who developed AEICS of the right lower leg following an 815-lb squat. He presented with delayed onset right calf pain, weakness, and creatine kinase (CK) elevation exceeding 93,000 IU/L. Despite an emergent four-compartment fasciotomy, he sustained a persistent right foot drop. This case highlights the diagnostic challenge of AEICS in nontraumatic settings, the potential role of anabolic steroids as a predisposing factor, and the importance of timely recognition and decompression to prevent permanent neurologic deficits.

Hot-iron disbudding is the most commonly used method for horn bud removal in dairy calves. Although factors such as post-treatment care, calf age, and the type of hot iron used have been studied in relation to wound healing, procedural factors, such as application time and tip size, have received little attention. The objective of this study was to evaluate the effects of hot-iron application time and tip size on wound characteristics and healing progression. Female Holstein calves (n = 24) were randomly assigned to 1 of 2 application times: 10 s versus 20 s. Within each calf, one horn bud was disbudded using a small tip and the other with a large tip. Disbudding was performed at 28 d of age using multimodal pain management (sedation, local nerve block, and analgesics). Wound size and depth were measured on the day of disbudding and every 3 d thereafter until the wounds had fully healed. Wounds were also photographed for classification of tissue type. Wounds resulting from the large tip were larger and shallower than those created with the smaller tip, requiring more time to achieve a crust-free state (51.9 ± 2.04 d vs. 45.3 ± 2.04 d). Wounds from the 20-s application were larger and deeper than those from the 10-s application, but this did not result in increased time to a crust-free state. Evidence of residual horn tissue after disbudding was observed in 18 of the 24 buds treated with the small tip versus 6 of the 24 treated with the large tip. These findings suggest that a smaller tip size can reduce wound size and shorten healing times following hot-iron disbudding, but can also increase the risk of horn tissue development; however, application duration appears to have a negligible influence on healing.