This case report describes a man with C1-C2 cervical myelopathy due to an os odontoideum. Over a span of 30 years, the patient developed weakness of his left lower limb, which gradually spread to all four limbs. The diagnosis was not made for three decades despite several medical consultations, a myelogram, and a computed tomography scan of the brain. This case illustrates that neurological disease due to spinal chord compression can have a long history, and demonstrates how advances in magnetic resonance neuroimaging contribute to a definite and accurate diagnosis.

The development of intracranial tuberculoma during treatment for tuberculosis have been described previously. A decrease in steroid therapy was thought to be responsible. We report a 30-year-old woman with tuberculous meningitis who developed brainstem tuberculoma while being treated with corticosteroids and anti-tuberculous therapy.

A 36-year-old man with a chronic hepatitis C infection developed hyperthyroidism from a previously normal thyroid status. Laboratory tests showed both elevated serum thyroxine and anti-thyroid antibody titres. The patient's hyperthyroidism was brought into remission by the administration of anti-thyroid medication. Graves' disease is a possible autoimmune manifestation of chronic hepatitis C not associated with interferon therapy. The mechanism may be due to antigen mimicry, epitope modification, or T-cell activation by the hepatitis C virus. New treatment modalities may be more effective than interferon therapy for chronic hepatitis C patients with thyroid disorders.

Focal fatty change of the liver is a rare and poorly recognised entity. Most of the previously reported cases occurred in patients suffering from the usual steatogenic conditions, such as diabetes mellitus and obesity. The focality of the lesion, however, remains unexplained. The author reports a rare case of subcapsular focal fatty change of the liver occurring in a 60-year-old Chinese woman suffering from poorly controlled adult-onset diabetes mellitus. The underlying pathogenesis for the focal fatty change is thought to be related to local ischaemic effect secondary to diabetic angiopathy, which may further enhance the steatogenicity of diabetes mellitus. The recognition of focal fatty change of the liver is important in order to avoid misdiagnosis of other space-occupying lesions radiologically and macroscopically.

We report the case of a 25-year-old woman who presented with paralytic ileus, interstitial cystitis and bilateral hydronephrosis with systemic lupus erythematosus being the probable underlying aetiology. This uncommon association-the first case described in our locality-may represent a specific subgroup found in lupus patients.