Pubic symphysis osteomyelitis associated with costal osteitis caused by Staphylococcus aureus after trauma: A case report.

Osteomyelitis of the pubic symphysis is a rare infectious disease commonly caused by the opportunistic bacteria Staphylococcus aureus and Pseudomonas aeruginosa. The clinical context includes fever, and pubic, or abdominal pain, thus should prompt a biological, microbiological, and radiological assessment. We report the case of a 16-year-old patient who developed inflammatory pygalgia in a febrile context laboratory examination showed an elevation of C-reactive protein and sedimentation rate. Pelvic X-rays and magnetic resonance showed bilateral bone lysis and destruction of the edges of the pubic symphysis, in addition to a pubic pelvic collection. Bacteriological examination revealed by methicillin-sensible S. aureus. The patient was put on antibiotic therapy for 2 months with good clinical and radiological evolution without surgical debridement. In conclusion, osteomyelitis of pubic symphysis can be misdiagnosed because of its atypical manifestations. Recovery is often achieved if adequate treatment is started early.

Foot involvement in psoriatic arthritis: Prevalence, clinical and radiological features.

BACKGROUND: The purpose of this study was to evaluate the prevalence of foot involvement in psoriatic arthritis and to describe its different clinical and radiological features. PATIENTS AND METHODS: We conducted a cross sectional study including 40 patients with psoriatic arthritis over a period of 12 months. Anamnesis, clinical examination of feet, podoscopic examination, X-rays of feet and heels, and ultrasound in B mode and power Doppler mode were done for each patient. RESULTS: Foot involvement was found in 95% of cases. It was symptomatic in 70% and inaugural of the disease in 20% of cases. The hindfoot and the forefoot were the sites most affected (77.5% and 47.5% respectively). The involvement of the midfoot was rarer (25%). Dactylitis was found in 17.5% and deformities of forefoot were found in 22.5% of cases. Antalgic gait was noted in 17.5% and static disorders of foot at podoscopic examination were identified in 35% of cases. Feet dermatological manifestations were found in 45% of cases. Diagnosis of different rheumatological manifestations was based on clinical findings and caracteristic radiological images on X-rays. We demonstrate he sensitivity of ultrasound in the detection and the diagnosis of different foot lesions including enthesitis, synovitis and tenosynovitis, dactylitis, bone erosions and psoriatic nail dystrophy.

Multifocal hydatidosis with extensive involvement of the sacrum and the femoral head.

Key Clinical Message: Hydatidosis is a parasitic infection caused by the larval form of "Echinococcus granulosis." Bone localization is rare even in endemic areas. We report an unusual case of an extensive hydatidosis of the right sacrum and femur with muscle involvement. Abstract: We report the case of a man, with a history of visceral hydatidosis, who developed after 14 years an extensive hydatidosis of the sacrum and femur with muscle involvement. The treatment of visceral hydatidosis was chemotherapy with albendazole for a long term. Conservative surgical treatment is considered for bone locations.

Spinal Paget's disease with bilevel cord compression and ischemic non-compressive myelopathy treated with zoledronic acid.

Cord compression and ischemic non-compressive myelopathy are a complication of spinal Paget's disease (SPD). SPD usually touches a single spine level. We report an unusual case with bilevel spinal cord compression and dysfunction which was medically treated due to resolution of the vascular steal syndrome.