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Introduction: A combined lesion, in which the ulna is fractured, and the radial head is dislocated means a complicated injurie of the elbow and was described by Giovanni Monteggia (1762-1815). These injuries are usually caused by high-energy trauma to the outstretched, slightly flexed arm. Case Report: In our case, a 39-year-old man who fell from an ATV off-road presented on 14/01/2024 with a swollen elbow joint. The X-Ray showed a Monteggia lesion, in which he suffered a proximal segmental ulnar shaft fracture, a dislocation of the radial head and an additional multi-fragment fracture of the olecranon. The fracture is classified by Bado and in this case determined as a subclassification by Jupiter IID, which means it is an extended fracture from the olecranon to the diaphysis. After the preoperative measures, the operation took place on 17/02/2024. The surgical approach was chosen via the posterior side of the fractured ulna up to the olecranon. For the open reduction internal fixation (ORIF) of the ulna a proximal ulna prebent locking plate (LCP) was used. Due to the high comminution presented by shaft of the ulna, the fracture was reconstructed on the plate with the aid of temporary K-wires. The construct was further stabilized with cerclage sutures. Fluoroscopy check-up showed the relocation of the radial head, thus proximal extension into a Speed and Boyd's approach was not necessary. Posto-operatively the arm was immobilized in supination with a plaster cast for 2-3 weeks. The healing process is going well so far, but further measures, like further further X-rays and physiotherapy are needed to maximise the outcome. Discussions : It is challenging to choose the right surgical method in such complicated cases. It should include treatment of the fracture, the correct position of the radial head, the olecranon should be stable and the attaching muscles should remain as functional as possible to ensure adequate movement. The other surgical option would have been a combination between a 3.5 dynamic compression plate (DCP) for the ulnar shaft fracture and the "figure of eight - technique" for the olecranon fracture. Either a LCP or a DCP plate can be used, but in our case the LCP plate was more adequate to prevent the olecranon from slipping off. Conclusions: Monteggia fractures are complicated lesions that need precise surgical treatment due to favorable restrictions in movement and future arthrosis and pseudoarthrosis, as well as chronic pain. [ABSTRACT FROM AUTHOR]

Introduction: Atypical Kawasaki Disease (KD), also known as incomplete Kawasaki, is a systemic vasculitis primarily affecting the pediatric population. It is characterized by a prolonged unexplained fever lasting five or more days, with fewer than four classical KD symptoms, such as conjunctival injection, oral mucosal changes, cervical lymphadenopathy, polymorphous rash, and extremity changes. Atypical KD often presents with laboratory indicators of systemic inflammation and may show abnormalities in the coronary arteries on echocardiography. Case Report: The aim of this paper was to provide a comprehensive description of a 34-month-old male patient who developed atypical KD following exposure to COVID-19. The case highlighted clinical presentation, diagnostic challenges, management strategies, and outcomes. Despite being fully vaccinated and having no significant medical history, the patient experienced persistent fevers that did not improve with antipyretic treatment. Laboratory tests revealed elevated markers of inflammation, including leukocytosis, CRP, ESR, Ferritin, and GOT. Cardiological evaluation was required due to coronary artery dilation observed on echocardiogram. Early intervention was crucial to prevent serious cardiac complications in KD. Discussions : The case report brought attention to the difficulties involved in diagnosing atypical KD within the context of post-viral multisystem inflammatory syndromes, specifically Multisystem Inflammatory Syndrome in Children (MIS-C), which can occur after exposure to COVID-19. The patient's clinical presentation of unexplained fever, systemic symptoms, and laboratory markers of systemic inflammation raised suspicion for incomplete KD. Echocardiography played a crucial role in confirming the diagnosis by demonstrating coronary artery dilation, a characteristic finding in KD. The absence of classical symptoms in atypical KD lead to challenges in distinguishing it from other post-viral inflammatory syndromes. In this case, the patient's exposure to COVID-19, along with the temporal relationship between the viral infection and symptom development, raised suspicion for atypical Kawasaki Disease. Elevated inflammatory markers and echocardiographic findings supported the diagnosis. Early intervention with IVIG treatment resulted in positive outcomes and reduced long-term cardiac complications. The association between COVID-19 and Kawasaki-like syndromes, such as MIS-C, was increasingly acknowledged. Healthcare providers should consider Kawasaki disease in pediatric patients with fever and systemic inflammation after COVID-19 exposure. Conclusions: This case emphasized the challenges in diagnosing atypical KD in post-viral inflammatory syndromes, highlighted the importance of early recognition and intervention to prevent cardiac complications, and underscored the role of echocardiography in confirming the diagnosis and guiding management. [ABSTRACT FROM AUTHOR]

Introduction: Takayasu's arteritis is a type of vasculitis that affects large blood vessels, primarily involving the aorta and its main branches. This condition is marked by granulomatous inflammation. It is predominantly found in women, with a female-to-male ratio of 9:1 and is more common in young Asian women under 40 years of age. Patients with this condition may have fever, joint pain, angina pectoris, syncope and weakened or absent pulses in the arms. Therefore, Takayasu's arteritis is sometimes referred to as "pulseless disease." Case Report: We report the case of a 30-year-old female patient who had a history of chronic arterial hypertension when she was brought to the hospital. After experiencing a brief ischemic event, an ultrasound revealed that the patient had carotid stenosis. For further evaluation, the patient was referred for a carotid and thoraco-abdominal CT angiogram. The brachiocephalic truncus showed mild parietal thickening extending circumferentially to the right common carotid artery. Tubular stenosis of the right common carotid artery with a reduction of the vascular lumen of approximately 50% and a wall thickening of approximately 5.5 mm, extended from its emergence to the origin of the right external carotid artery. Circumferential thickening of the aortic wall affected the ascending aorta from the level of the sino-tubular junction to the left common carotid artery, with a maximum wall thickness of approximately 5 mm at the level of the ascending aorta. The descending thoraco-abdominal aorta was also affected from the level of the T9 vertebra to the origin of the inferior mesenteric artery, with a maximum wall thickness of approximately 4 mm adjacent to the L3 vertebra. Overall, the abdominal aorta exhibited a significantly uneven diameter, with narrower and more enlarged areas alternating. Both renal arteries and the celiac trunk had a narrowing of the ostia of up to 50% due to the wall thickening. Discussions : CT plays a vital role in diagnosing and monitoring of Takayasu arteritis. It provides detailed images of affected vessels, revealing wall thickening, stenosis, and inflammation. CT angiography, in particular, offers a non-invasive way to visualize both the extent and severity of vascular involvement, guiding treatment decisions and helping assess the disease progression and response to therapy. Conclusions: Our study presents a case of Takayasu's disease, focusing on elucidating the significant contribution of imaging modalities in its diagnostic process. [ABSTRACT FROM AUTHOR]