Unusual Occurrence of Tenosynovial Giant Cell Tumor in Hoffa's Fat Pad: A Potential Differential Diagnosis for Nontraumatic Knee Swelling and Pain.

A tenosynovial giant cell tumor (TGCT) is a benign lesion whose presence in Hoffa's pad has rarely been reported. This unique case report discusses a 33-year-old female patient who presented with swelling and pain in her left knee. Clinical and MRI findings were used to make the diagnosis, which was confirmed on a histopathological basis. The patient had a large tumor (5 × 3 × 3 cm) in Hoffa's fat pad, which was diagnosed as TGCT and managed with open resection due to its size. At follow-up after 20 months, the patient was asymptomatic, and there was no local recurrence of the tumor.

Ganglion cyst of Hoffa's fat pad of knee-a rare cause of knee pain and swelling-a case report and literature review.

Ganglion cysts around knee joint are uncommon and that from Hoffa's fat pad are even rarer. We present a case of 30 year old male patient with complaint of pain and swelling in left knee joint. Radiograph did not show any bony abnormality. MRI showed large tubulocystic lesion within Hoffa's fat pad which showed low signal intensity on T1-weighted images and high signal intensity on T2-STIR images. Open excision of the lesion was done. Histopathology of the specimen confirmed the diagnosis of the ganglion cyst. In follow-up, patient had asymptomatic left knee with full range of motion and did not show any sign of recurrence. Ganglion cysts from fat pad though very rare but should be considered in differential diagnosis to have an early diagnosis and management. Symptomatic ganglion cyst should be excised by open procedure or arthroscopically depending upon the size and extent of the lesion.

Efficacy of alternate day Directly Observed Treatment Short-course (DOTS) in skeletal tuberculosis - A retrospective study.

OBJECTIVE: To assess the efficacy of alternate day (thrice a week) Directly Observed Treatment Short-course (DOTS) regimen spanning six to nine months in providing sustained cure for skeletal tuberculosis (TB) under programmatic conditions. DESIGN: Retrospective cohort study. SETTING: An urban district tuberculosis centre in India under the Revised National Tuberculosis Programme. PARTICIPANTS: A cohort of 218 patients treated with alternate day DOTS regimen for skeletal TB between 2007 and 2012. METHODS: All patients with the diagnosis of skeletal TB registered between 2007 and 2012 who successfully completed treatment were followed up for evidence of disease recurrence or relapse using structured interviews conducted between August 2013 and October 2015 after ensuring a minimum follow up of two years. RESULTS: Of the 200 patients eligible for follow up in this study, 117 (58.5%) had a minimum follow up of two years. The remaining 83 cases could not be traced. 105 (89.7%) of these 117 patients were symptom free for two years or more after the completion of treatment. There were four cases who had a relapse of the disease within two years of completion of treatment. Eight cases were administered further ATT soon after the completion of treatment under DOTS. CONCLUSIONS: This study confirms the efficacy of the alternate day DOTS regimen in successfully treating all forms of skeletal TB, including spinal TB, with a success rate of 89.7%.

Epidemiological features of skeletal tuberculosis at an urban district tuberculosis centre.

Skeletal tuberculosis is an important component of extra-pulmonary tuberculosis. It can lead to substantial morbidity and poses serious occupational and economic problem. We conducted a study in an urban District Tuberculosis Centre (DTC) to assess the burden and distribution of skeletal tuberculosis in the community. Our centre was catering to a population of 6-7 lakhs between 2007 and 2012. During this period, we treated 11,274 cases of tuberculosis. Out of these, 3086 (27.3%) were cases of extrapulmonary tuberculosis and 219 (1.94%) were cases of skeletal tuberculosis. Skeletal TB predominantly affects the young Indian population with incidence peaking in the second and third decades of life. 172 patients (78.5%) in our study were new cases. There were no drugs resistant (DRTB) skeletal TB cases till we concluded our study. Tuberculosis commonly involves joints more than long bones. The spinal column was the most commonly involved skeletal site affecting 62.6% of all cases. The rate of spinal TB in our study is much higher than that reported in literature. The high number of patients calls for close co-ordination between managing orthopaedic surgeons, treating physicians and DOT providers to ensure adequate patient care.

A rare complication of a metacarpophalangeal joint replacement in a rheumatoid hand: a case report.

Metacarpophalangeal joint replacement is one of the most common surgery performed for rheumatoid hand deformities. The systemic and progressive nature of rheumatoid arthritis and other inflammatory arthritis make isolated assessment and treatment of metacarpophalangeal joint joints challenging.Extensive joint involvement and systemic nature of the illness has an impact in the prognosis of the illness. The long term outcome of the surgical procedure depends on how best the illness is controlled. Technical aspects of the surgery in patients with rheumatoid arthritis can be widely variable and can make implant arthroplasty challenging. We present a case report of an unusual presentation of a rare complication following metacarpophalangeal joint replacement performed 17 years ago.

Exercise induced chronic compartment syndrome of the first dorsal interosseous compartment of the hand: a case report.

Exercise-induced chronic compartment syndrome in the first dorsal compartment is an uncommon entity and relatively rare condition which is not very well understood. It is a usually activity-related condition and is associated with decreased function of muscle with intracompartmental swelling. We present a case with proven exercise-induced raised compartment pressure that responded well to surgical fasciotomy.

Successful closed manipulation of a pure lateral traumatic dislocation of the elbow joint using a modified Stimson's technique: a case report.

INTRODUCTION: Pure lateral elbow dislocation is rare, and a successful closed reduction is even rarer. Reduction can be hindered by swelling, soft tissue interposition or associated fractures. CASE PRESENTATION: We present a pure lateral traumatic dislocation of the elbow joint in a 40-year-old man. This was successfully manipulated and reduced in casualty using a modification of the gravity-aided 'hanging arm' technique originally described for shoulder dislocations by Stimson. CONCLUSION: We strongly recommend the use of this simple technique in these rare yet difficult injuries, in order to avoid potential complications with general anaesthesia and surgery.

A tip on using the appropriate wire passer in orthopaedic surgery.

The authors present a technical tip on using the appropriate wire passer while passing cerclage wires around long bones in orthopaedic surgery.