ABSTRACT
McCune-Albright syndrome is an inherited disease characterized by the association of fibrous dystrophy of bone, café-au-lait skin spots and precocious puberty revealing endocrine hyperactivity. Genetically, this disease is due to a mutation of the Gs protein responsible for activation of adenylate cyclase with excessive production of cAMP. The particular morphology of café-au-lait spots should suggest early diagnosis. Its treatment depends on the endocrinopathy from which the patient suffers and the extent of the fibrous dysplasia. Bisphosphonates have proven their effectiveness on bone pain and the limitation of fibrous dysplasia. Surgery retains its place in complicated forms. We report a rare case of McCune-Albright syndrome complicated by a femur fracture in a 12-year-old girl and we discuss the clinical and paraclinical characteristics of this pathological entity.
Subject(s)
Fibrous Dysplasia of Bone , Fibrous Dysplasia, Polyostotic , Puberty, Precocious , Female , Humans , Child , Fibrous Dysplasia, Polyostotic/diagnosis , Puberty, Precocious/diagnosis , Puberty, Precocious/etiology , Cafe-au-Lait Spots/etiology , Cafe-au-Lait Spots/complications , MutationABSTRACT
Subungual exostosis is a benign, uncommon osteocartilaginous tumour that tends to recur. We here report the case of a 17-year boy with subungual exostosis, who reported a history of trauma. Treatment was based on direct surgery. The tumor was completely excised. The postoperative course was uneventful, with no recurrence identified.
Subject(s)
Bone Neoplasms , Exostoses , Nail Diseases , Male , Humans , Exostoses/diagnosis , Exostoses/surgery , Exostoses/pathology , Nail Diseases/diagnosis , Nail Diseases/surgery , Nail Diseases/pathology , Bone Neoplasms/diagnosis , Bone Neoplasms/surgery , Bone Neoplasms/pathology , Postoperative PeriodABSTRACT
The treatment of acute osteomyelitis is becoming more challenging since the emergence of community-acquired methicillin-resistant Staphylococcus aureus. We collected data on all patients with acute osteomyelitis caused by this germ over a period of 21 years (January 1995-December 2016) and we analyzed the peculiarities of this disorder. Our case series includes 15 children, with an average age of 9 years. All patients had affected lower limb. Local trauma was reported in 8 cases and skin carriage in 4 cases. Acute onset was reported in 12 cases associated with pseudo-paralysis of the affected limb. One patient had Staphylococcus aureus pulmonary infection with signs of septicopyemia. Blood culture was positive in 8 cases. In one case PCR assay for detection of Panton-Valentine leukocidin was performed with positive result. All these patients underwent surgical debridement and received secondarily adapted empirical antibiotic therapy. Outcome was good in 8 cases and poor in the other cases, with transition to a chronic state in 6 cases and one case of death. Pathological fracture was reported in 3 cases. Osteomyelitis cause by community-acquired methicillin-resistant Staphylococcus aureus is associated with a pejorative outcome. Recognizing the clinical and paraclinical signs of these infections is essential for a specific and early therapeutic management.
Subject(s)
Community-Acquired Infections/diagnosis , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Osteomyelitis/diagnosis , Staphylococcal Infections/diagnosis , Acute Disease , Adolescent , Anti-Bacterial Agents/administration & dosage , Child , Child, Preschool , Combined Modality Therapy , Community-Acquired Infections/microbiology , Community-Acquired Infections/therapy , Debridement/methods , Female , Humans , Male , Osteomyelitis/microbiology , Osteomyelitis/therapy , Retrospective Studies , Staphylococcal Infections/microbiology , Staphylococcal Infections/therapyABSTRACT
Old fractures and dislocations of the base of the fifth metacarpal may result in post-traumatic arthrosis which is troublesome from a functional point of view and characterized by a difficult management. Stabilized arthroplasty is based on arthroplastic resection of the base of the fifth metacarpal associated with lateral diaphysometaphyseal arthrodesis between the fourth and the fifth metacarpal. This study involving two patients aimed to describe the advantages and the peculiarities of stabilized arthroplasty compared to other techniques in the treatment of the sequelae of fractures and dislocations of the base of the fifth metacarpal.
Subject(s)
Arthroplasty/methods , Joint Diseases/surgery , Metacarpal Bones/surgery , Adult , Arthrodesis/methods , Humans , Joint Diseases/etiology , Joint Diseases/pathology , Joint Dislocations/etiology , Joint Dislocations/pathology , Joint Dislocations/surgery , Male , Metacarpal Bones/injuries , Metacarpal Bones/pathology , Young AdultABSTRACT
Tuberculosis of the shoulder is rare. It encompasses all articular and periarticular tuberculouses of the shoulder. Its insidious evolution, mimicking inflammatory and degenerative diseases, reflects the frequency of its diagnostic delay. We report a rare case of tuberculous bursitis of the shoulder in a woman living in rural areas, with renal insufficiency and treated for peritoneal TB and psoas. The anamnesis revealed signs of tuberculous impregnation. Clinical examination showed painful swelling of the shoulder associated with stiffness. MRI of the shoulder objectified infectious bursal disease. Its tuberculous origin was confirmed by the histological examination of ultrasound-guided synovial biopsy. The patient underwent TB treatment with good outcome. At 9-year follow-up, the patient had satisfactory articular function with no recurrence of infectious disease.