Pediatric Sciatic Neuropathy Secondary to Subacute Ischial Osteomyelitis: A Case Report

Sciatic neuropathy (SN) is rarely encountered in the pediatric population. The causes of this mononeuropathy are either infectious, immune mediated, toxic, or infiltrative (tumoral). In this article, we presented the case of a 7.5-year-old male child who presented to the emergency department with a painful right lower limb. Magnetic resonance imaging confirmed the diagnosis of subacute osteomyelitis of the ischium, which extended toward the external hip rotators and infiltrated the tissues around the sciatic nerve. Treatment with intravenous antibiotics (flucloxacillin 50 mg/kg/d and gentamicin 10 mg/kg/d) rapidly improved the child's condition and relieved neurological symptoms within a few days. Traumatic and iatrogenic injuries are the most common causes for SN. To our knowledge, this presented case is the first to describe SN due to an infectious process following subacute osteomyelitis.

Pseudocystic Osteosarcoma: A Potential Diagnostic Pitfall – Case Report

Introduction: Pseudocystic osteosarcoma (OS) is an uncommon variant of conventional OS. Clinical and radiological features are presented as benign process with a non-rapid growth rate. Treatment may be adversely affected by the delay in diagnosis or an appropriate invasive procedure. Case Presentation: We report a rare case of pseudocystic OS of the distal femur in a 6-year-old boy. Imaging findings revealed an osteolytic intra-compartmental tumor, that suggested either simple bone cyst or subacute osteomyelitis. The patient was first operated by lateral approach for curettage but histopathology showed conventional OS. Treatment had been managed by standard current chemotherapy and trans-epiphyseal intercalary resection through lateral approach. Reconstruction was done by a non-vascularized autograft within the induced membrane technique. At 3 years of follow-up, the patient remained disease-free with good anatomical and functional results. Conclusion: conventional OS can be presented in rare cases as a benign bone cyst tumor. This type of pseudocystic OS should be included in the differential diagnosis of bone cyst tumors and pseudo-tumors. Keywords: Osteosarcoma, pseudocystic, surgery, reconstruction.

Pretibial varicose veins with anomalous intraosseous venous drainage: A rare disease entity

We present a case of pretibial varicose veins with intraosseous perforating vein incompetence, which manifested as swelling and tenderness over the shaft of tibia. It was misdiagnosed by referring clinicians as a case of subacute osteomyelitis based on clinical findings and X-ray film. Further investigations were done which included magnetic resonance imaging, computed tomography scan, and color Doppler.

Moraxella lacunata Subacute Osteomyelitis in a Child

Moraxella lacunata is a rare coccobacillus associated with eye and upper respiratory tract infections. It may also have an affinity for bone and joint tissue. We report on 1 case of subacute osteomyelitis of the patella due to M. lacunata that presented as an osteolytic bone lesion in a child.

Brodie's Abscesses Can Stimulate the Growth Plate in Children

Introduction: We present a series of children with lower limb Brodie's abscesses (subacute osteomyelitis) with subsequent deformities.Method: A retrospective examination of the paediatric bone and joint infection database from 2014-2017 was performed. All children have MRI scans and blood tests including full blood count, ESR and CRP. MRI identified collections were drained surgically.Results: There were 68 children with bone and joint infections, and 6 had a Brodie's abscess. 4 Brodie's abscesses were adjacent to a growth plate, all these had resultant growth deformities. Some deformities develop up to 3 years after initial presentation.Discussion: We recommend long-term vigilance for growth deformity after a Brodie's abscess. In particular we demonstrate that infection can result in stimulation of the physis, as opposed to growth retardation as generally accepted.