Infectious tuberculous tenosynovitis (TS) of the extensor tendons of the wrist is an exceptional location of musculoskeletal tuberculosis. We present a case of tuberculous extensor TS in a 52year-old diabetic male patient presenting as a huge mass on the dorsum of the hand, in the absence of other pulmonary or extrapulmonary manifestation of tuberculosis. This report increases physicians' vigilance when dealing with patients with risk factors of tuberculosis, allowing early diagnosis and optimal treatment.
Cutaneous squamous cell carcinoma (cSCC) is relatively rare in the heel and foot. It is characterized by great loco-regional aggressiveness but low metastatic potential. If left untreated, cSCC can grow to a large diameter. The rarity and unfamiliarity of this condition pose therapeutic difficulties to many surgeons. We hereby submit the case of a 32-year-old male patient presenting with a large 14 x 8 cm scaly, ulcerated, and bloody skin lesion covering the entire left heel and invading the calcaneus. The patient was treated with radical excision of the mass and a reverse sural fasciocutaneous flap to cover the remaining heel defect, with a very positive outcome and no complications.
This case is presented due to the rarity of the squamous cell carcinoma of the heel, and its large size (14 x 8 cm) in a relatively young patient, especially when it is invading the calcaneus.
Case:
An 18-year-old adolescent boy presented with knee pain and stiffness secondary to tibial plateau valgus malunion and osteochondral defect, 8 months after initial injury/fixation. We opted for a novel technique that reconstructs the convex lateral tibial plateau by using osteotomy and an osteochondral autograft harvested from the lateral aspect of the ipsilateral femoral condyle.
Conclusion:
The reported novel reconstruction technique is inexpensive, achievable with routine techniques, and demonstrated a favorable short-term outcome. At 3 years of follow-up, the patient had excellent, asymptomatic, left knee mobility and function with radiographic evidence of mild posttraumatic arthritis despite normal knee alignment.
Talar injuries represent serious medico-surgical conditions because of the involvement of the talus in multiple articulations, such as the subtalar, the transverse talar, and the ankle joint complex. Its complete detachment from the surrounding ligaments and bone is known as talar extrusion, a very rare injury with a complicated treatment course. We report a case of a 43-year-old female patient presenting with a non-retrieved complete left talar body extrusion associated with a floating knee, manifested by left tibial shaft fracture and left supracondylar femoral fracture. The patient was treated with open reduction and internal fixation for the floating knee and a manually shaped talar cement spacer with staged tibiocalcaneal arthrodesis for the ankle. The patient was monitored over a six-year period. This case is reported for the extreme rarity of lost open talar body extrusion, and its problematic treatment in the absence of clear guidelines, especially with the presence of multiple concomitant ipsilateral fractures of the limb, such as floating knee, as in this case.
Osteoid osteoma is a benign osteogenic bone lesion, typically found in patients aged between 5 to 25 years. It is recognized by its clinical picture in the form of a regional nocturnal pain that is relieved by NSAIDS, and by its characteristic radiographic appearance as a small (<1.5 cm in diameter) lesion with a sclerotic margin and radiolucent nidus. Osteoid osteoma is rare in the pediatric population younger than 5 years-old. The differential diagnosis in this age group for lytic lesions osteomyelitis, osteochondroma, stress fractures, histiocytosis, bone cysts, and malignancies. We present a case of 4-year-old boy presented with a 1-month history of limping, and right ankle pain diagnosed with osteoid osteoma. Treatment consisted of simultaneous intralesional biopsy and radiofrequency ablation under fluoroscopic guidance. We report this case for the rare occurrence of an osteoid osteoma in a very young patient (<5 years-old), its atypical location in the talus, and its presentation as pain not relieved by NSAIDS. The inclusion of this pathology in the differential diagnosis in the pediatric age group leads to an effective and simple treatment, and avoids unwarranted and costly workup and interventions.
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