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We report on the case of a 40-year-old male who was admitted to the clinic with a large ulcer on his left buttock, 3 days after an intramuscular benzathine penicillin injection. The patient was diagnosed with Nicolau syndrome, a rare vascular complication in which a lesion develops after intramuscular injection. Symptoms are intense pain at the injection site, erythema, and livedoid dermatitis, which leads to necrosis of skin, subcutaneous tissue and muscle tissue. It was described by Nicolau after intramuscular injections of bismuth salt for syphillis therapy. Nicolau syndrome is rare, but its symptoms are devastating and healthcare professionals must be aware of this clinical entity, since intramuscular injections are common procedures for administration of drugs. [ABSTRACT FROM AUTHOR]

The supracondylar process is a hook shaped projection of the humerus. It is located superior to its medial epicondyle. This anatomic variation is often presented together with the Struther's ligament, a fibrous arcade that connects the supracondylar process to the medial epicondyle. Both structures have been associated with neurovascular bundle compression on the distal third of the arm, as the median and ulnar nerves and the brachial and ulnar arteries may pass through the osteofibrous canal that these variants create. The SciElo, Pubmed, Scopus, TRIP, MEDLINE, COCHRANE and ScienceDirect databases were searched with the term "supracondylar process" or "supracondyloid process" with the purpose of performing a meta-analysis of this bony spur. Heterogeneity between studies was evaluated using I2 estimation and the Cochran Q statistic test. A random effect model was used for all analysis. A total of twenty articles (26.415 humeri) were included in this meta-analysis. The pooled prevalence of the supracondylar process was 0.68 % (95 % Confidence Interval: 0.47 % to 0.92 %). This variant was more commonly found in women than in men (statistically significant difference) and more commonly found on the left side than the right. The presence of the supracondylar process alone may induce neurovascular bundle compression. It can also be injured in traumatic or stress fractures. Knowledge of this variation and its prevalence may reduce misdiagnosis in radiographic images. [ABSTRACT FROM AUTHOR]

During an ordinary dissection, a cadaver showed a bilateral anomalous origin of the deep brachial artery, where this vessel appeared like a branching of the subscapular artery with common trunk, which included the posterior circumflex humeral artery. The course and distribution of the deep brachial artery in the back compartment were relatively consistent with previous reports. Arterial variations can be damaged through iatrogenic means if not properly documented. The knowledge of this case is very important in clinical medicine and in surgeries in this compartment to prevent any injury. [ABSTRACT FROM AUTHOR]