This syndrome should be considered a potential cause of hip pain, particularly if the patient is physically active, but there is no literature evidence of kinase inhibitor Trichostatin A abdominal symptoms. However, stretching of the iliopsoas muscle can elicit flank pain in a retrocecal appendix, as it is in contact with the psoas muscle; in fact in many patients the psoas sign is positive (11,12). Moreover, patients with a pelvic appendix may show no abdominal signs but the obturator sign may be present, again due to anatomical considerations. For these reasons, when the US result is ambiguous and psoas or obturator signs are present, a CT should be carried out. CT is the most accurate study for evaluating patients without a clear clinical diagnosis of acute appendicitis: its sensitivity and specificity (both 100%) are both superior to US (sensitivity 77% and specificity 86%) (14).

The use of CT to evaluate potential appendicitis has decreased the negative appendectomy rate from 42.9% to 3.3% in women aged 18�C45 years and may be useful for the diagnosis of rare diseases that mimic acute appendicitis (13,14). Conclusions This case reports evidence that herniation pits of the right femoral neck should be considered a potential cause of right lower abdominal pain that mimics an acute appendicitis, particularly if the psoas sign and obturator sign are positive and the patient is physically active. We suggest a more focused use of preoperative imaging such as CT scan, especially in females of reproductive age, when ultrasound (first choice test) is non-diagnostic or unclear.

CT scan can diagnose rare diseases, such as HPs, and help prevent unnecessary surgery, thus reducing the negative appendectomy rate and its associated costs. Fig. 1 CT showing herniation pit on the right femoral neck.The giant cell tumor of tendon sheath (GCTTS) is the most common benign neoplasm in the hand after the ganglion cyst. Several hypotheses were formulated about the etiological factors of these tumors, but still there is not a common opinion on etiology, prognostic factors and recurrence rate. This article presents a review of literature of the last 15 years about GCTTS to assess the demographic, clinical and histological profile. We compared the information obtained from literature with our experience of 64 cases between 2000 and 2012. Our study showed similar results to those reported in literature, except for the recurrence rate: only 3 cases (4.

7%) of 64 patients reported recurrence (versus about 15% on average in literature). Among the various possible factors that predispose to recurrence, it is necessary that the surgeon ensures complete excision of the tumor and removal of any residual Entinostat satellite nodules. Although the marginal excision is the treatment of choice, it is often difficult to perform due to for the location and the strict adherence of the tumor to the tendon or neurovascular bundles.