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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Case report
Full Version
Magnetic Resonance Imaging and Ultrasound Evaluation of Chronic Lateral Malleolar Bursitis: A Case Report
Correspondence Address :
Dr. Jaypradha Saravanan,
Postgraduate Resident, Department of Radiology, Saveetha Medical College and
Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha
University, Chennai, Tamil Nadu, India.
E-mail: jaymdrad@gmail.com
Chronic lateral malleolar bursitis is an unusual cause of lateral ankle swelling that can mimic tendon, joint, or soft-tissue disorders. Present case report is of a 48-year-old male farmer with a 7-month history of painless, fluctuant swelling over the right lateral malleolus. High-frequency Ultrasonography (USG) of the right ankle revealed a focal, well-defined effusion/cystic lesion in the subcutaneous plane/ lateral malleolar bursa, characterised by multiple mobile echogenic lenticular structures (rice bodies) with minimal internal vascularity. Magnetic Resonance Imaging (MRI) of the right ankle revealed T2 weighted (T2W) and Proton Density Fat Saturation (PDFS)- a focal hyperintense fluid collection (effusion)/cystic lesion in the subcutaneous plane/lateral malleolar bursa containing multiple T2W and PD FS hypointense rice bodies, with no involvement of the peroneus tendons, bone marrow, or adjacent neurovascular structures. Aspiration and histopathology revealed fibrinous rice bodies with chronic inflammatory cells with no evidence of granulomatous infection, confirming the diagnosis of chronic lateral malleolar bursitis. This case demonstrates the simultaneous use of USG and MRI to describe the superficial bursae in real time, assess the extent of involvement, and rule out deeper extension.
Ankle, Neurovascular structures, Rice bodies, Surgical drainage
A 48-year-old male farmer came to the emergency room with swelling on the lateral aspect of his right ankle, which gradually increased in size over a period of seven months. The patient had no history of trauma. There were no associated systemic symptoms. Upon further questioning, the patient gave a history of prolonged squatting and sitting cross-legged while farming. These postures cause friction between the lateral aspect of the ankle and the ground. The patient recently had difficulty wearing shoes due to swelling, which prompted him to seek medical attention. There was no prior history of tuberculosis, rheumatoid arthritis, or other chronic inflammatory or infectious disorders. This history was obtained specifically because of the established correlation between rice body formation and tuberculous and rheumatoid bursitis.
In addition to having no known co-morbidities such as diabetes mellitus, hypertension, or immunosuppressive disorders, the patient had no major prior medical or surgical history.
During the examination, a localised, fluctuant swelling above the lateral malleolus was noted. No break-up/hyperpigmentation/ pulled-up appearance/puckering was seen (Table/Fig 1). The patient did not report pain; however, examination revealed mild restriction of ankle range of motion on the affected side compared with the contralateral limb; formal goniometric measurements were not performed.
A radiograph of the right ankle showed a peri-articular/juxta-articular focal radio-opacity and soft-tissue swelling in the lateral malleolar region, measuring ~ 62×25×58 mm (anteroposterior x transverse x craniocaudal). The central area appeared homogeneous with no calcifications or fat content, while the margin appeared illdefined medially and smooth laterally. Visualised bones (distal tibia, distal fibula, and talus) appeared normal. Visualised joints (distal tibio-fibular, tibio-talar, and talo-crural joints) appeared normal (Table/Fig 2)a, (Table/Fig 2)b].
The USG of the right ankle (transverse and longitudinal scans) showed a focal cystic lesion/fluid effusion in the subcutaneous plane/ lateral malleolar bursa of size ~ 65×23×55 mm (anteroposterior x transverse x craniocaudal), volume ~ 45-50 cc, central multiple mobile, echogenic, lenticular-shaped structures with no posterior acoustic shadowing (likely rice bodies), and minimal increased colour flow (vascularity) on colour doppler and peripheral smooth to macro-lobulated margins (Table/Fig 3), (Table/Fig 3)b, (Table/Fig 3)c.
The MRI of the right ankle showed T2W, PDFS- hyperintense cystic lesion/fluid effusion in the subcutaneous plane of lateral malleolar bursa of size ~ 65×25×60 mm (anteroposterior x transverse x craniocaudal), volume ~ 45-50 cc, with central multiple hypointense foci/structures (likely rice bodies), and peripheral smooth to macrolobulated margins (Table/Fig 4)a, (Table/Fig 4b), (Table/Fig 4)c. Based on clinical and imaging findings, chronic lateral malleolar bursitis was considered.
The patient underwent incision and drainage of the bursal fluid, while taking steps to avoid infection. A small cut was made over the lateral malleolus, and the fluid was drained. There were many small, whitish rice bodies in the bursal cavity. The sample was sent for examination under a microscope. The wound was closed in layers after the cavity was thoroughly cleaned. They were careful not to injure the nearby tendons and neurovascular structures. On the second postoperative day, the patient was discharged, since the postprocedural period was uneventful. At follow-up after two and four weeks, there were no signs of infection or recurrence, and the site had healed properly. The patient was told to perform ankle range-of-motion and strengthening exercises to regain mobility and prevent stiffness. He was told to gradually return to normal activities. Medical management was not preferred due to the large size of the lesion, the presence of multiple rice bodies, and progressive swelling, which caused functional limitation (difficulty in wearing footwear). Therefore, surgical drainage was performed to achieve definitive symptomatic relief and to obtain material for histopathological evaluation.
Histopathological Examination (HPE) of the cystic lesion/effusion reveals rice bodies consisting of dense eosinophilic fibrin, foamy macrophages with vacuolated cytoplasm, multinucleated giant cells exhibiting clustered nuclei, and synovial lining hyperplasia along the bursal wall, thereby confirming chronic inflammatory bursitis with rice body formation. No granulomas or acid-fast bacilli were found (Table/Fig 5). Chronic lateral malleolar bursitis was diagnosed based on HPE findings.
A bursa is a cyst with a synovial lining that is usually found above a bony prominence to reduce friction with tendons or tissues under the skin (1). Bursitis is a common condition that can occur anywhere in the body. There are two types of bursa: adventitious and anatomical. Aberrant shear strain is the cause of the adventitious bursa, which is frequently found in subcutaneous tissue (2) around the lateral malleolus. Bursitis, inflammation of a bursa, can result from injury, repetitive stress, infection, or a systemic inflammatory disease. The lateral malleolar bursa, which is located above the lateral malleolus, is an adventitious bursa that can become inflamed due to long-term friction (3). Lateral malleolar bursitis happens on the dorsolateral part of the foot, over the lateral malleolus. The condition has been observed in miners who sit with their legs crossed in tunnels with low ceilings (4) or in figure skaters, and is attributed to abnormal contact pressure and shear stresses on their malleoli from their boots (5).
Recent literature further supports the varied aetiopathogenesis and clinical spectrum of lateral malleolar/pre-malleolar bursitis. Naito M et al., described a case of recalcitrant lateral premalleolar bursitis associated with chronic ankle instability, wherein a communicating tract between the bursa and ankle joint via the extensor digitorum longus tendon sheath acted as a “check-valve” mechanism, leading to persistent swelling and recurrence. Surgical resection along with ligament repair was required for definitive management (6).
Similarly, Kim J et al., in a retrospective study of 19 patients with synovial fistula associated with lateral ankle instability, demonstrated that abnormal communication between the joint and periarticular soft tissues plays a crucial role in persistent or recurrent swelling. Imaging modalities, including MRI, were essential in identifying the fistulous tract, associated ligamentous injury, and extent of disease (7). In contrast, the present case did not demonstrate any communication with the joint or associated ligamentous instability on MRI, suggesting a non-communicating adventitious bursa likely secondary to chronic external friction.
The differential diagnoses evaluated included ganglion cyst, peroneal tenosynovitis, soft-tissue neoplasm, and infective bursitis, including tuberculous bursitis. A ganglion cyst was considered; however, the presence of multiple internal, mobile, echogenic rice bodies and minimal vascularity on USG was atypical. The MRI did not show any tendon sheath fluid, tendon thickening, or involvement of the peroneal tendons, so peroneal tenosynovitis was ruled out. A softtissue neoplasm was considered unlikely, as the lesion was solely cystic, devoid of solid components or aggressive traits. Infective bursitis, especially of tuberculous origin, was excluded due to the lack of systemic symptoms, a negative clinical history, and the absence of granulomas or acid-fast bacilli in histopathological analysis.
Chronic lateral malleolar bursitis is an uncommon but significant cause of swelling on the lateral aspect of ankle. Imaging methods, specifically, USG and MRI are highly significant in accurate diagnosis since they aid in characterisation of the lesion which guides appropriate management for the patient.
DOI: 10.7860/JCDR/2026/87822.24241
Date of Submission: Jan 30, 2026
Date of Peer Review: Mar 16, 2026
Date of Acceptance: May 15, 2026
Date of Publishing: Sep 01, 2026
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Mar 14, 2026
• Manual Googling: May 11, 2026
• iThenticate Software: May 13, 2026 (2%)
ETYMOLOGY: Author Origin
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