Assessing tophaceous spinal gout treatment response using dual-energy CT as a point-of-care imaging modality: case report.

We describe a case of chronic tophaceous gout affecting the spine, hands, elbows, feet, and knees in a 67-year-old man with serum urate levels at 549 µmol/L whose response to treatment was successfully mapped using dual-energy computed tomography (DECT). The patient presented with exacerbation of acute-on-chronic lumbar back pain. He had received a diagnosis of gout 3 years prior to this presentation yet was not on any urate-lowering therapy.

The uncrossed-doubled patellar tendon: A novel imaging finding.

A spectrum of anatomic variants of the conventional single patellar tendon have been described however a double patellar tendon is a highly rare finding, which has only been described once before where a cross-over tendon morphology was illustrated. We report the case of a 46-year-old man with a 3 month history of left knee pain who was found to have an incidental double patellar tendon without cross-over, with one deep bundle demonstrating a more conventional patellar tendon course, paralleled by a second anatomically-distinct superficial bundle of differing morphology coursing anterolateral to the deep conventional bundle, explicitly connecting patella to tibial tuberosity. A comprehensive understanding of the anatomic variations of the patellar tendon is essential for both radiologist and clinician to deliver safe clinical practice.

Physiological role for nitrate-reducing oral bacteria in blood pressure control.

Circulating nitrate (NO(3)(-)), derived from dietary sources or endogenous nitric oxide production, is extracted from blood by the salivary glands, accumulates in saliva, and is then reduced to nitrite (NO(2)(-)) by the oral microflora. This process has historically been viewed as harmful, because nitrite can promote formation of potentially carcinogenic N-nitrosamines. More recent research, however, suggests that nitrite can also serve as a precursor for systemic generation of vasodilatory nitric oxide, and exogenous administration of nitrate reduces blood pressure in humans.