Botchu-Beale accessory ligament of lateral ankle

Variations in anatomy of the tendons and ligaments are not uncommon and cause a diagnostic dilemma. We describe a novel ligament encountered in the ankle extending from posterior inferior tibiofibular ligament to calcaneum. Awareness of normal variant is essential during evaluation of a study.

Normal Variant Distribution among Elderly Patients Who Visited Airlangga University Dental Hospital

Background and Objective. A normal variant of the oral cavity in humans, especially when aging, indicates how the body adapts to the environment, a lifestyle, and irritation. This study aimed to examine the distribution of normal variants among elderly patients who visited Airlangga University Dental Hospital. Method. This was a descriptive observational design study. Examination of oral soft tissue was performed on elderly dental patients who came to the hospital from January to December 2019. Results. Sixty-eight (68) elderly patients, 60 years of age and over, 35 males and 33 females. The study identified 138 normal oral variations of soft tissues and oral structures. The three highest distributions obtained were coated tongue, lingual varicosities, and fissured tongue. Conclusion. The normal variants of oral mucosa and oral structure in the elderly resulted from how the body adapted to the environment and the awareness of the systemic disease that might occur.

Asymmetric Lateral Ventricles—A Tale of Two Cases

Asymmetry of the lateral ventricles is not an uncommon finding. On one end, it is a predictor of intracranial pathology, and on the other, it can represent a normal variant. It needs to be appropriately investigated. In this case report, we presented two cases of asymmetric lateral ventricles, their presentation, progression and management.

Isolated Upward Rotation of the Fetal Cerebellar Vermis (Blake’s Pouch Cyst) Is a Normal Variant: An Analysis of 111 Cases

<b><i>Introduction:</i></b> The objective of the study was to provide more detailed data about fetal isolated upward rotation of the cerebellar vermis rotation (Blake’s pouch cyst) in particular regarding pregnancy outcome. <b><i>Methods:</i></b> This is a retrospective study of all cases of fetal isolated upward rotation of the cerebellar vermis (URCV) diagnosed in 3 referral centers in Italy from January 2009 to November 2019. Whenever possible, prenatal magnetic resonance imaging (MRI) was performed and a fetal karyotype was obtained. A detailed follow-up was obtained by consultation of medical records, interview with the parents, and the pediatricians. <b><i>Results:</i></b> Our study population included 111 patients with a prenatal diagnosis of isolated URCV made at a median gestational age of 21 weeks +3 days (interquartile range (IQR) 21 + 0–22 + 2). The median brain stem-vermis (BV) angle was 27° (IQR 24–29°). In 37.9% of the cases, a regression of the finding with restoration of normal anatomy was noted at a follow-up scan or at postnatal checks. A BV angle of 25° or less predicted regression with a probability in excess of 90%. MRI was performed in utero or at birth in 101 patients and always confirmed sonographic diagnosis. Fetal CGH array and/or karyotype was available in 97 cases and was always normal, but in 1 case. A postnatal follow-up was available in 102 infants (mean 7 months, range 0–10 years of age) and documented a normal neurologic development in all the cases. <b><i>Conclusions:</i></b> Isolated URCV is most likely a normal variant of fetal anatomy without clinical consequences, at least at an early follow-up. A BV angle of 25° or less predicts intrauterine regression of the finding, but the outcome is good in all the cases. When a confident sonographic diagnosis is made, MRI is not mandatory. The risk of a chromosomal anomaly in these cases is probably low.

Vulvar vestibular papillomatosis: All genital lesions are not sexually transmitted diseases

Vulvar vestibular papillomatosis (VVP) is considered as normal anatomical variant of the vulva. A 19-year-old female presented with asymptomatic pinkish filliform papules symmetrically distributed on vulva. She denied having any sexual exposure. Clinical differential diagnosis included genital wart and vestibular papillomatosis, however biopsy was consistent with Vestibular papillomatosis. PAS stain was negative. Application of 5% acetic acid did not show any change in color. We report this case to create awareness about normal variant of vulva and unnecessary exaggerated treatment and proper counseling of patient to decrease psychological trauma and associated venereophobia.