key: cord-0069854-cv55f94s
authors: Lee, R.
title: Benevolent running
date: 2021-11-12
journal: Br Dent J
DOI: 10.1038/s41415-021-3630-7
sha: 6458485b2e7396f4d878a5b79a65576bab48648b
doc_id: 69854
cord_uid: cv55f94s

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can appear in up to 25% of episodes and an exceptional finding that has been reported is subconjunctival haemorrhage, as described by Young et al. 3 in 2018. Other authors have also described the presence of burning or a throbbing sensation accompanying this disorder. 4 The diagnosis is fully clinical, but as mentioned above, the intensity of the pain leads these patients to go to the emergency system where an exhaustive anamnesis and a good physical examination are sufficient to guide the recognition of the pathology. 4, 5 The main differential diagnoses are coagulation disorders, rheumatological pathologies and vascular disorders. Therefore, physical data such as pain, and the persistence of normal temperature, differentiate it from pathologies such as acrocyanosis, where the skin becomes cold and there is no pain. This entity, unlike Raynaud's syndrome, does not worsen with cold, nor does it have trophic changes. 2, 5 Diagnostic aids such as radiography are important to rule out bone alterations, since Achenbach's syndrome often appears during physical activities. Doppler echotomography is effective to rule out a circulatory compromise at the distal level of the limb, and blood analysis determines normality in coagulation tests, and even allows ruling out the presence of rheumatological alterations. 2, 5 Treatment is usually supportive due to the benign and self-limited course of the syndrome; therefore, once the diagnosis has been oriented and pathologies of another nature have been ruled out, the natural history of the disorder must be explained to the patient since it has been shown that it is recurrent, although the triggering or predisposing situations are not exactly known. The use of analgesics and non-steroidal anti-inflammatory drugs are usually sufficient to manage pain and oedema. 4 

Achenbach's syndrome

Achenbach's syndrome: Case report and systematic review of the literature

Recurrent subconjunctival haemorrhage in Achenbach's syndrome

Personal observations of Achenbach syndrome

Spontaneous digital hematoma, Achenbach Sindrome