Listeria monocytogenes septic arthritis in a patient treated with mycophenolate mofetil for polyarteritis nodosa: a case report and review of the literature.

Listeriosis can be a cause of arthritis. Here, we present a case of Listeria monocytogenes septic arthritis of the right hip in a 66-year-old male treated with mycophenolate mofetil for polyarteritis nodosa. So far, septic arthritis due to this microorganism has not been reported in patients treated with mycophenolate mofetil. We review the literature of L. monocytogenes septic arthritis and discuss the role of mycophenolate mofetil treatment in precipitating listeriosis.

Limb salvage in Ewing's sarcoma of the distal lower extremity.

BACKGROUND: Ewing's sarcoma (ES) of the foot and ankle is a rare condition whose treatment is controversial. There are no large series covering this issue. Some authors advise amputation as the "gold standard" treatment. The authors here prsent their experience in limb salvage of fourteen cases of ES in distal lower extremities. METHODS: The clinical records of fourteen patients affected by ES in ankle or foot were reviewed. Particular attention was paid to followup, functional status, type of treatment, survivorship and histological response to treatment. RESULTS: Straightforward amputation was employed in just 3 cases of toe location, and another case located in the calcaneum was considered unresectable. Limb salvage was achieved in most patients with tumors in tarsal and metatarsal bones, as well as distal tibia and distal fibula locations. There were no local recurrences of the tumor. All but on patient survived after a minimum follow-up of four years (4 to 22). The function at the last follow-up was excellent or good in 80% of cases of limb salvage, mainly in non-irradiated patients. CONCLUSIONS: Chemotherapy and resection with reconstruction of the foot yielded excellent results in ES cases. Survivorship of ES in distal locations seems to be better than for proximal ones. High doses of radiotherapy and amputation can be avoided in the treatment of these tumors.

Nail-patella syndrome: long term evolution.

Nail-patella syndrome is a rare dysplasia characterized by a typical tetrad: hypoplasic nails, hypoplasic or absent patella, radial head dislocation and iliac horns. We review eight patients, four men and four women, aged from 20 to 70 years. The main complaint at consultation was with their knees due to patellar instability and pain. Five of them required surgical treatment due to patellar dislocation and three patients were not treated. The Krogius-Lecène procedure was performed in four patients with a good result following the Insall classification of pain and instability and with an average follow-up of 24 years (range, 18-28 years). Patellectomy was performed in the eldest patient due to femoropatellar arthritis present at first consultation. No patients presented with elbow or nail disorders or with iliac horns.