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Les calcifications discales sont le plus souvent révélées chez l'enfant, par des crises douloureuses rachidiennes. Leur localisation cervicale, semble être la plus fréquente. Cependant, les autres localisations sont moins symptomatiques et pourraient ainsi passer inaperçues. Nous rapportons deux observations d'enfants hospitalisés pour des calcifications discales cervicales symptomatiques. Il s'agit : du cas d'une fillette âgée de quatre ans et demi ayant présenté un torticolis, révélateur de la migration d'une calcification discale jusque-là asymptomatique ; et de celui du garçon âgé de 05 ans venu pour cervicalgie aigue et chez qui une calcification discale a été retrouvée. Leur traitement était essentiellement conservateur. Les calcifications discales intervertébrales de l'enfant sont une pathologie rare dont l'étiopathogénie reste inconnue. Leur diagnostic ne doit pas se faire sans un examen neurologique attentif et une imagerie devant des douleurs rachidiennes inexpliquées chez l'enfant.The Pan African Medical Journal 2016;25

A full-term baby boy required moderate resuscitation at birth. Clinical examination revealed a painless lump of the right clavicle. Radiographically, the borders of the two fragments were sclerotic (Fig. 1) and follow-up US showed no callus formation. These findings confirmed the diagnosis of congenital pseudarthrosis of the clavicle (CPC). CPC results from failed coalescence of the two primary ossification centres of the clavicle; the true mechanism of this condition remains unknown [1, 2]. It occurs almost always on the right side and very rarely bilaterally. The larger medial segment always lies above the smaller lateral segment. On both sides of the pseudarthrosis, features of enchondral ossification and fibrocartilage are found [1]. Diagnosis in the neonatal period has been rarely reported, with the lesion usually found during the first 2 years of life [2]. The function of the shoulder is not impaired, although an non-aesthetic painful deformity or thoracic outlet syndrome may occur during and/or after the growth period. Surgery, consisting of resection, bone grafting and osteosynthesis is usually performed at a mean of 6 years of age [1]. There are two differential diagnoses. Cleidocranial dysostosis is easily excluded by the absence of hypoplastic clavicles and a wide pubic symphysis. It is important to differentiate CPC from birth trauma; in the latter, callus formation occurs very quickly.

Forty-two children with nontuberculous spondylodiscitis treated between 1966 and 1997 were reviewed, and the clinical, paraclinical, and therapeutic results are presented. The study shows the difficulties of diagnosis and understanding the pathophysiology of the disease. Additional information is provided by new imaging techniques, disc aspiration, and biopsy. The mean age at treatment was 4 years 6 months. The initial clinical presentation was often misleading and the diagnosis was often delayed (42 days average). Standard radiographs and technetium bone scans were important for diagnosis and patient follow-up. Magnetic resonance imaging and needle aspiration of the disc gave an additional reliable aid in differential diagnosis and helped to guide treatment. Bacteria were isolated in 22 of the 35 samples taken (55% Staphylococcus aureus, 27% Kingella kingae; Coxiella burnetii in one sample). The functional outcome is good if treatment is properly carried out. Disc fibrosis and occasional vertebral fusion develop inevitably in the long term. According to these results, nontuberculous spondylodiscitis is truly osteomyelitis of the spine.