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La tuberculose osseuse est une maladie infectieuse qui constitue un veritable probleme de sante publique dans les pays en voie de developpement ou elle sevit de maniere endemique. L'atteinte osteo-articulaire represente 1 a 5% des cas de tuberculose toutes localisations confondues, l'atteinte de l'epaule reste tres rare et represente 1 a 2% des localisations osteo-articulaires. Nous presentons ici un nouveau cas exceptionnel d'une infection tuberculeuse de l'omoplate, atteignant le corps de l'omoplate. La tuberculose est encore un diagnostic differentiel important des maladies rares ou chroniques des os, notamment tumorales. Le diagnostic a ete redresse par l'etude anatomopathologique. Mots cles: Omoplate, tuberculose, enfant English Title: Scapular involvement: uncommon presentation of childhood tuberculosis English Abstract Tuberculosis of bone is an infectious disease which represents a major public health problem in developing countries where it is endemic. Osteoarticular involvement accounts for 1-5% of all cases of tuberculosis, shoulder involvement is very rare and accounts for 1-2% of all cases of osteoarticular tuberculosis. We here report an uncommon case of TB infection involving the scapula, reaching the scapular body. Tuberculosis is still an important differential diagnosis of rare or chronic bone diseases, including tumors. In our study anatomopathological examination led to the diagnosis. Keywords: Scapula, tuberculosis, child

Neglected trauma of the elbow in the child is not rare, especially in countries where traditional treatment is still practiced. The authors report a study of 57 neglected elbow trauma in children and the complication of stiffness managed in the pediatric orthopedics department in Rabat, Morocco, between 1996 and 2002. Average patient age was 11 years, location predominated at the right elbow, and the average delay of consultation was 7 months after the trauma. Clinical examination found 36% of stiffness in bending, 29% in extension, and 35% mixed. Of these, 43% were judged very serious, 20% serious, and 37% moderate. Radiological finding showed 35 neglected elbow dislocations (61%), ten supracondylar humeral fractures (17%), and 12 posterior lesions difficult to determine. Abstention from surgery was recommended for 12 patients; 45 were operated on. The end result was 53% with minimal and moderate stiffness. The authors analyzed clinical and therapeutic aspects of all lesions, insisting on abstention from surgery according to the variable and unforeseen character of surgery results.

Authors report an exceptional localization of tuberculosis in children. Tuberculosis became a pathology of high incidence in the last 20 years, even in industrialized countries. Localization in the talus is rarely reported (less than 100 pediatric cases worldwide). The authors report on observation of isolated bone tuberculosis of talus in a 20-month old boy. Isolated infection of the talus by Koch's bacillus (KB) is extremely rare; only a few rare cases in the child and at the adult have been reported in the literature. In our observation, a delay of 6 week was necessary to make diagnosis of bone tuberculosis. Reasons for this delay, and some diagnostic and therapeutic aspects of this disease, are discussed here. Tuberculosis of the talus must be considered before any other inflammatory ankle disease.

Introduction . – We retrospectively reviewed 106 pediatric cases of peripheral osteoarticular tuberculosis (OAT) seen over a 21-year period in Morocco. Patients with vertebral tuberculosis were excluded from the study. Patients and results . – The 55 boys and 51 girls had a mean age of 8 years. The hip and knee together contributed 63% of the osteoarticular foci. Organ involvement was documented in 32 cases. Mean time from symptom onset to evaluation was 10 months. This resulted in diagnostic delay, which contributed to the 22% rate of residual abnormalities consisting of joint ankylosis and leg length inequality. Conclusion . – OAT is a source of functional disability that should be recognized and treated early, particularly in children, given that appropriate management can lead to a full recovery (14 patients in our series).