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INTRODUCTION: Skeletal tuberculosis is the great mimicker of lesions, usually manifesting in a non-specific image. Though it enters the differential diagnosis of every lesion in immature skeletal bones, it is commonly misdiagnosed. Early and correct diagnosis is crucial due to the distinct required treatment. CASE PRESENTATION: A 5-year-old male complained of vague pain in the ankle without any other specific or major systemic symptoms. A cystic lesion was found on a plain X-ray, which turned out to be osseous tuberculosis, and it was treated successfully and followed up for two years. DISCUSSION: The primary method of treating appendicular skeletal tuberculosis is through lesional curettage and adjuvant chemotherapy without bone grafting. It is crucial to detect the disease early for a better prognosis. Unfortunately, it is often diagnosed late, and Conservative treatment is not always successful. CONCLUSION: Tuberculosis should be considered for long bones lesions in children, and it can be successfully treated with surgery and chemotherapy.
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INTRODUCTION: Hemangioma is a unique benign vascular tumor. Intramuscular seated lesions tend to cause pain, swelling, and disability in adulthood, especially after a traumatic aggravating event. PRESENTATION OF CASE: A young, healthy female suffered a previous trauma to her left forearm. Persistent pain developed after it with intermediate swelling that turned out to be a deep-seated hemangioma, which was treated successfully with excision. DISCUSSION: Though it is often a benign-acting congenital lesion, with several treatment methods, early diagnosis of hemangioma is a dilemma. Expelling other similar malignant lesions is essential. Surgical intervention could be necessary and effective in specific indications. CONCLUSION: Adequately planned surgery can successfully manage traumatic aggravated intramuscular hemangioma.
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INTRODUCTION: Total knee arthroplasty is an effective procedure that aims at restoring function and relieving pain. While most surgeons are familiar with primary TKA, some secondary cases are unique and might create a challenge. CASE PRESENTATION: A young 30-year-old male with no comorbidities had a gunshot injury to his knee. He developed knee arthritis later, which was treated with modular TKA and a cement-screws technique for substitution for bone loss. DISCUSSION: Complex cases of TKA demand innovative solutions, many options exist now for dealing with various challenges, but they are expensive and not always available, so other choices must be utilized to afford the best possible outcome. CONCLUSION: Post-traumatic TKA could be technically challenging, and screws buttressing the cement could effectively handle bone defects when other options are unavailable.
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INTRODUCTION AND IMPORTANCE: Osteoid osteoma is a benign bone tumor that may resolve spontaneously and commonly affects adolescents in the proximal femur region and causes characteristic pain. Although benign, it can relapse and severely deteriorate function when juxta-articular. Its recurrence rate varies according to the treatment method used. CASE PRESENTATION: This article presents a case of a 21-year-old male with a recurrent calcar osteoid osteoma that was successfully treated by surgical en bloc excision; Harris Hip Score of 97.00 %. The lesion was previously managed through an intralesional curettage and an autologous iliac crest bone graft. CLINICAL DISCUSSION: The treatment of osteoid osteoma varies from medical therapy with NSAIDs or minimally invasive surgery to traditional open surgery. The surgical approach aims to excise the nidus, remove the pain, avoid growth disturbance in immature skeletons, and limit the side effects of long-term NSAID use. CONCLUSION: Radiofrequency ablation is the standard therapy for osteoid osteoma nowadays; unfortunately, it is unavailable in some countries due to the high cost and lack of equipment and specialists. En bloc excision may be the ideal approach for recurrent cases after intralesional curettage.
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INTRODUCTION AND IMPORTANCE: Giant cell tumor of tendon sheath (GCTTS) is a common soft tissue tumor in hands and feet; however, it is rare in knee joints. CASE PRESENTATION: We present a case of a 52-year-old female who had a retropatellar tendon giant cell tumor (GCT) in the right knee, causing vague anterior knee pain. CLINICAL DISCUSSION: Anterior knee pain is a challenging complaint in orthopedics due to the multiple causative reasons, the combination of several complex etiologies, and the lack of clear guidelines for an effective treatment. CONCLUSION: This case report aims to shed light on unlikely pathologies in complex cases. GCTTS is a rare lesion to affect the retropatellar region. However, we must keep it in mind when dealing with challenging anterior vague knee pain complaints. A comprehensive examination is essential; surgical experience and extended follow-up are mandatory for avoiding complications.
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INTRODUCTION: Quadriceps contracture can be congenital or acquired; however, multiple intramuscular injections are one of the major identified causes of this lesion that can manifest in two forms: either isolated rectus femoris or combined with quadriceps contracture. CASE REPORT: this article presents a case of a 9-year-old boy with a recurrent isolated rectus femoris contracture that was released proximally with a satisfactory result after one-year follow-up. DISCUSSION: Treatment differs based on the degree of knee flexion loss and the affected muscles, as it can be either proximal release or distal quadricepsplasty. Extended physiotherapy and close follow-up are mandatory for successful treatment. CONCLUSION: Proximal release of the hip flexion contracture with positive Ely's test can be effective in restoring knee flexion and improving function in patients with quadriceps contracture induced by iatrogenic injection.
