Late presented case of distal humerus epiphyseal separation in a newborn.

The incidence of traumatic bone injuries occurring during birth is rare (1 per 1000 live births). Of all long bone fractures, the humerus is one of the commonest bones to be involved. However, distal humeral epiphyseal separation is rare and has seldom been written up in case reports and small case series. It warrants some critical assessment and appropriate attention. This injury is sometimes missed as it is difficult to diagnose at initial presentation. It may be mistaken for dislocation of the elbow, osteomyelitis, septic arthritis or brachial plexus injury, owing to lack of movement of the upper limb. Knowledge of its clinical and radiological findings will enable the treating physician to diagnose it at the appropriate time. Masterful observation is adequate treatment for this condition, and leads to a better clinical and radiological outcome. Timely diagnosis with an optimistic prognosis will prevent unnecessary parental apprehension.

Dyspnea in a case of shoulder dislocation - to beware of this rare life-threatening symptom.

Shoulder dislocation is a common injury in orthopedic practice. In an acute presentation, closed reduction of the shoulder joint leads to an uneventful recovery. However, in the developing world neglected shoulder dislocation and treatments from quacks are not uncommon. Improper treatment and neglect can rarely become life threatening. We present one such case, emphasizing the need to investigate the symptom of dyspnea in a patient with history of shoulder dislocation.

Intra-articular osteoid osteoma of the distal humerus: a diagnostic challenge.

Osteoid osteoma rarely presents in an intra-articular or juxta-articular location, leading to synovitis and flexion deformity, which can easily mislead the diagnosis. We present a case of an intra-articular osteoid osteoma of the distal humerus in a 19-year-old woman with pain and flexion deformity of the elbow. Although radiographs were normal, a nidus was demonstrated on CT scan. Appropriate surgical treatment provided relief to the patient and the diagnosis was confirmed on histopathology. Thus, an intra-articular osteoid osteoma may be mistaken for more common causes of synovitis unless there is an index of suspicion and appropriate imaging is undertaken.

Thorn-induced pseudotumour of the fibula.

Foreign body granulomas are common in the hand and foot. Diagnosis of the same is often delayed or missed, especially in unusual locations and in the paediatric age group. Radiographs usually reveal an osteolytic lesion with absence of periosteal reaction and non-metallic foreign bodies are not visualised in plain radiographs. An ultrasound and MRI can delineate the foreign body. Clinical and radiological presentation mimics that of a tumour and hence is rightly called pseudotumour. We present a case of thorn-induced pseudotumour of the fibula in a 5-year-old boy.