ABSTRACT
Osteoid osteoma is a primary, benign, bone tumor with a typical X-ray appearance. The diagnosis is usually straightforward when it involves the long bones of the leg. However it may occur in unusual locations, such as in flat and cancellous bones. The following case demonstrates the difficulty in diagnosing it in an extremely rare site. A 25-year-old woman with long-standing anterior, right knee pain had had 3 interventions: 2 diagnostic arthroscopies and a distal, femoral biopsy. Since there had been no improvement in her condition, the diagnosis of osteoid osteoma of the patella was suggested, supported by recent X-ray and scintigraphic findings. This rare condition was confirmed by biopsy of the upper pole of the patella, a procedure that was followed by complete recovery. 6 years later, she is now completely free of pain and has no clinical or X-ray evidence of recurrence. Review of the literature revealed only 5 previously reported cases of osteoid osteoma of the patella. All were diagnosed relatively late and in 1 the tumor was diagnosed only after total patellectomy. Diagnosis of these rare cases that mimic much more common causes of patello-femoral pain demands a high index of suspicion.
Subject(s)
Osteoma, Osteoid/diagnosis , Patella , Adult , Biopsy , Female , Humans , Osteoma, Osteoid/diagnostic imaging , Osteoma, Osteoid/pathology , Pain/etiology , Patella/pathology , RadiographyABSTRACT
Entrapment of the ring finger flexor digitorum in the ulna following fracture of both forearm bones is very rare. Only three cases have been reported previously (Jeffrey, 1976; Rayan and Hayes, 1986). We report another case of such entrapment in an 8-year-old boy.
Subject(s)
Fractures, Closed/complications , Tendons , Ulna Fractures/complications , Bony Callus , Child , Fingers , Humans , Male , Muscular Diseases/etiology , Radius Fractures/complicationsABSTRACT
This paper describes a new technique for greater trochanteric hip arthroplasty in which the femur is divided at the subtrochanteric level and the upper fragment rotated through 180 degrees to place the greater trochanter deeply in the acetabulum; with the lower limb in the weight-bearing position the fragments are then fixed with a short intramedullary nail. This operation was carried out in a boy aged 4 years 6 months in whom the femoral head and neck had been destroyed by septic arthritis. Ten years later leg-lengthening was performed. When reviewed at the age of 20, he had a stable hip, a satisfactory range of painless movement, and shortening of only 2.5 cm; he could walk and run for long distances with only a slight abductor lunch.