 Hello, I'm Dr. Fahne, JNCO, Department of Rehabilitation and Drug Advances from GMCH Alakabar, and I'll be presenting a case report on Cripple-Kadena syndrome of the upper limb. I'm presenting a case of a 50-year-old male who came with complaints of prominent results of the right upper limb and right side of chest and back region, which was present since childhood. They had no history of trauma or no family history and other limbs were nowhere. On local examination, the patient had skin discoloration over his upper limb, right chest, and back region with no elevated temperature. As per the clinician's request, we performed a CT angiography. On the arterial phase, we observed that the bilateral upper limb arterial system were normal. This is a 3D reconstruction, it means depicting the same. On venous phase, on CT venography, we observed multiple dilated tortuous venous channels in subcutaneous plane of right arm and forearm. This is the coronal and societal reconstruction images showing, again showing, the subcutaneous dilated tortuous venous channels. This video is the same showing dilated tortuous venous channels in subcutaneous plane of the right arm and forearm region. Also, we can note that the deep venous system, a base hypoplastic type tuft of tiny tortuous venous channels are noted along the course of the brachial artery and which is eventually draining into the axillary pain. This is a 3D reconstruction image showing the multiple dilated tortuous venous channels over the right upper arm and forearm. On this image, we can see there is mild hypertrophy involving the right upper arm and forearm. Also, the mild hypertrophy of the right arm and forearm muscles are also noted. Also, we can see the visualized radius and ulna, then this image appears to be larger as compared to that on the left side. U.S.Doppler of the patient was done. On Doppler, the dilated vascular channels, not on the subcutaneous plane, was noted to be dilated venous channels. And also, the deep venous system was not well appreciated with the suggestion of hypoplasia or apricia. Based on these findings, limb overgrowth symptoms can be commonly of four varieties. Tape and Prenominoid syndrome, Park-Weber syndrome, Glove syndrome and Prodeus syndrome. Glove, which is congenital lipomatis overgrowth, vascular malformation, epidermal, naivitis, final anomalies were immediately ruled out. As lipomatis, hypertrophy of the limb is noted, which is not observed in this case. In Prodeus syndrome, the hypertrophy increases over time and it is not present since birth. Capillary malformation are present in both triplet and Park-Weber syndromes. But it is differentiated on the basis of the vascular malformation which is present. In triplet malformation, it is usually venous or low-flow vascular malformation, whereas in Park-Weber syndrome, it is arterial venous or high-flow vascular malformation. In this patient, there is a pod vein stain indicating capillary malformation, low-flow or venous malformation in the form of barico-cities and bony and soft tissue hypertrophy of the right upper limb was noted. And hence, the diagnosis of lipbalt-renovary syndrome of the right upper limb was kept. A brief discussion regarding the lipbalt-renovary syndrome. It consists of triad cutaneous capillary malformations in this patient's senous pod vein leeway and limb overgrowth, which may be bony or soft tissue hypertrophy, and barico-sveins or venous malformation with unusual distribution. The diagnosis is usually made when any two of these three features are present. And there's a prevalence of 1 in 100,000, including the related syndromes. And it is majorly the case of low-alum. In this patient, it is upper column, which are very, very rare. In silty angiography, the superficial barico-trainage is seen as described previously without a normal functioning deep venous system. On MRI, deteriorated MRI images may show malformed venous patients as areas of high signal intensity. MRI imaging shows deep extension of low-flow vascular malformations into muscular compartments, as well as bone or soft tissue hypertrophy. Regarding treatment problems, the application of created compressive stockings or pneumatic compression devices to the enlarged extremities are usually preferred, and which is done in our patient. Percutase clearosis or superficial barico-sveins are usually not preferred, as deep veins are usually hypoplastic in these cases. Surgical treatment like epifesiodesis is done to control the legular discrepancy and excision of soft tissue hypertrophy can also be. Complications include thromboflibitis or affected lymph or venous thromboembole cell. We have to understand how to generate urinary hemorrhage if there is visceral involvement and capillary malformations are large enough. We may sequester platelets into cassabaric syndrome. This comes up to quite a bit. Thank you.