Intramuscular myxoma of the hypothenar muscles.

Intramuscular myxomas of the hand are rare entities. Primarily found in the myocardium, these lesions also affect the bone and soft tissues in other parts of the body. This article describes a case of hypothenar muscles myxoma treated with local surgical excision after frozen section biopsy with tumor-free margins. Radiographic images of the axial and appendicular skeleton were negative for fibrous dysplasia, and endocrine studies were within normal limits. The 8-year follow-up period has been uneventful, with no complications. The patient is currently recurrence free, with normal intrinsic hand function.

Retained toothpick causing pseudotumor of the first metatarsal: a case report and literature review.

We present a case of a retained toothpick causing pseudotumor of the first metatarsal in a young female who was referred as a case of painless swelling in the dorsolateral aspect of the right foot to exclude a malignant tumor. Plain radiograph did show an osteolytic lesion in the head and neck of the first metatarsal. Magnetic resonance imaging revealed a toothpick inside the first metatarsal head. Surgical exploration revealed a 4 cm toothpick embedded inside the bone surrounded by granulation tissue. We could find seven cases of retained foreign bodies causing osteolytic lesions in the metatarsals of the foot with one case of osteomylitis in an adult due to a retained small piece of toothpick. Retained foreign body should be considered in the differential diagnosis of an osteolytic lesion of the foot.

Associated risk factors in children who had late presentation of developmental dysplasia of the hip.

PURPOSE: The purpose of this study was to assess the role of clinical examination, associated risk factors and plain radiograph of the pelvis in children who had late presentation of DDH. METHODS: We report on a 7-year prospective study, in children who had late presentation of developmental dysplasia of the hip (DDH). For this purpose, 740 hips in 370 referred children, age range 3-7 months (mean 3.44 months) were clinically and radiologically assessed, and the associated risk factors recorded. RESULTS: Female sex, first born, positive family history and breech presentation were confirmed as risk factors for DDH. Significant findings were an increased risk for vaginal delivery over caesarean section for breech presentation (P = 0.002). There was an increased risk for caesarean section in the absence of breech presentation. Multiple births and preterm births had a reduced risk. For breech presentation, the risk of DDH was estimated to be at least 1.6% for girls and 3.4% for boys; a combination of factors increased the risk. Limitation of abduction (43.2%) and asymmetry of the groin skin folds (72.7%) were found to be the two most common clinical findings associated with DDH. Bilateral acetabular dysplasia is more common than unilateral dysplasia. Foot deformities were rarely encountered in children with acetabular dysplasia. CONCLUSIONS: The percentage of first-born babies who had DDH is lower than reported in the literature (34%), but still shows significant risk. We did find that bilateral acetabular dysplasia is more common than unilateral dysplasia. Torticollis and foot deformities are rarely found to be associated with DDH. All these findings needs further evaluation in children who had surgical treatment for DDH, to see if they are different from dysplastic groups. Limitation of abduction is an important clinical finding, but is not always associated with DDH. Asymmetry of the skin folds in the groin were found to be an important clinical finding associated with DDH for all age groups. As clinical examination depends on many factors, and most DDH cases are of the dysplastic type, it is mandatory to depend on further diagnostic tools for confirmation of DDH.