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Objectif : Les tumeurs rétropéritonéales regroupent l’ensemble des tumeurs primitives qui naissent dans l’espace rétro et sous-péritonéal. L’imagerie occupe une place prépondérante dans le diagnostic et le suivi de ces tumeurs. Le but de notre travail était d’étudier la concordance radio-histologique des tumeurs rétropéritonéales de l’enfant. Matériel et Méthodes : Il s’agissait d’une étude transversale réalisée sur 09 ans (Février 2010 à Avril 2019) portant sur 132 enfants colligés dans les services d’Imagerie médicale et d’Oncopédiatrie de l’Hôpital Aristide Le Dantec (HALD). Les patients avaient été explorés par échographie et tomodensitométrie. Tous les patients avaient bénéficié du même protocole au scanner. Résultats : Plusieurs types histologiques étaient observés : Le néphroblastome (83%), le carcinome rénal à cellules claires (4%), le sarcome rénal à cellules claires (4%), le néphrome mésoblastique congénital (1%), le néphrome kystique (2%), l’angiomyolipome (1%), le neuroblastome (9%) et le lymphome de Burkitt (1%). Le néphroblastome était la tumeur la plus fréquente. Le neuroblastome était la tumeur qui donnait le plus de métastases. La sensibilité de l’échographie était de 100% pour le néphroblastome et le lymphome. La sensibilité du scanner était de 100% pour toutes les tumeurs sauf le sarcome rénal à cellules claires. Une concordance radio-histologique était observée dans 75% des cas. Conclusion : Les tumeurs rétropéritonéales sont largement dominées par le néphroblastome pour lequel le couple échographie-scanner possède une sensibilité de 100%. English title & abstract Iconographic review and radiohistological concordance of retroperitoneal tumors in children Objective : Retroperitoneal tumors include all the primary tumors that arise in the retro and sub peritoneal space. Imaging plays a major role in the diagnosis and monitoring of these tumors. The aim of our work was to study the radio-histological concordance of retroperitoneal tumors in children. Material and Methods: This was a cross-sectional study carried out over 09 years (February 2010 to April 2019) involving 132 children collected in the medical imaging and pediatric oncopediatrics departments of Aristide Le Dantec Hospital (HALD). The patients had been explored by ultrasound and computed tomography. All the patients had benefited from the same protocol on the scanner. Results: Several histological types were observed: Nephroblastoma (83%), renal clear cell carcinoma (4%), renal clear cell sarcoma (4%), congenital mesoblastic nephroma (1%), cystic nephroma (2%), angiomyolipoma (1%), neuroblastoma (9%) and Burkitt's lymphoma (1%). Nephroblastoma was the most common tumor. Neuroblastoma was the tumor that gave the most metastases. The sensitivity of the ultrasound was 100% for nephroblastoma and lymphoma. The sensitivity of the CT scan was 100% for all tumors except renal clear cell sarcoma. A radio-histological agreement was observed in 75% of cases. Conclusion: Retroperitoneal tumors are largely dominated by nephroblastoma for which the ultrasound-scanner pair has a sensitivity of 100%. Keywords: Imaging, tumor

Objectifs : Déterminer la prévalence de la pneumonie lipidique exogène, étudier les indications des examens d’imagerie et décrire ses caractéristiques radiologiques et tomodensitométriques.Patients et méthode : Une étude rétrospective multicentrique sur 6 ans, a concerné 14 nourrissons atteints de maladie de Hirschsprung, traités à l’huile de paraffine et présentant une pneumopathie chronique non tuberculeuse. Ils ont bénéficié de radiographies du thorax de face et / ou de tomodensitométries avec mesures de densité.Résultats : Le tableau clinique est univoque à type de détresse respiratoire dans un contexte de malnutrition avec hypoxie chronique, perte ou stagnation pondérale, conduisant aux examens d’imagerie. L’aspect et la distribution des lésions sont uniformes, faites de clartés non aériques à la radiographie et d’hypodensités graisseuses, postérieures dans 80 à 100% des cas et atteignant au moins deux lobes à la TDM. La prévalence est de 10,85% dans notre population.Conclusion : La PLE doit être évoquée chez le nourrisson atteint de maladie de Hirschsprung et traité à l’huile de paraffine, dès la survenue d’une pneumopathie sans signes biologiques évidents. La TDM permet de mettre en évidence l’hypodensité graisseuse caractéristique des lésions. Objectives : Determine the prevalence of exogenous lipid pneumonia, study the indications for imaging examinations in and describe its radiological and computed tomography characteristics.Patients and method : A six-year retrospective multicenter study involved 14 infants with Hirschsprung's disease treated with paraffin oil and with chronic non tuberculous pneumonia. They benefited from chest x-rays and / or tomodensitometry with density measurements.Results : The clinical picture is unequivocal in the type of respiratory distress in a context of malnutrition with chronic hypoxia, weight loss or stagnation, leading to imaging examinations. The lesions are uniform in appearance and distribution, with non-airy clarity on x-ray and fatty hypodensities, posterior in 80-100% of cases, reaching at least two lobes on CT. The prevalence is 10.85% in our population.Conclusion : The diagnosis of PLE should be made in infants with Hirschsprung's disease who are treated with paraffin oil as soon as they develop pneumonia without obvious biological signs. CT allows to highlight the characteristic fatty hypodensity within the lesions.

Resume Objectif L’objectif de cette presente etude etait d’evaluer l’âge majeur de jeunes sujets senegalais, avec les stades de maturation de Demirjian et l’indice de maturation de la troisieme molaire (IM3) de Cameriere. Materiels et methodes L’etude portait sur 299 radiographies panoramiques de sujets âges de 14 a 24 ans. L’IM3 est le rapport entre la somme des largeurs des ouvertures apicales des racines de la troisieme molaire et la longueur du plus grand axe. La valeur seuil de l’IM3 = 0,08. Un sujet est considere majeur (âge de 18 ans ou plus) si l’IM3 ˂ 0,08. La methode de Demirjian est basee sur les stades de maturation de la troisieme molaire mandibulaire de A a H. La sensibilite et la specificite etaient evaluees pour chaque methode. Resultats Les 53 % (n = 158) de l’echantillon etaient constitues de sujets de sexe masculin alors que le sexe feminin representait 47 % (n = 141). Le stade H presentait une sensibilite et une specificite respective de 92 % et de 85 % chez les hommes, de 89 % et 70 % chez les femmes. La sensibilite de l’IM3 a identifier un majeur comme tel etait respectivement de 93 % chez les hommes et 86 % chez les femmes. La specificite de 82 % chez les hommes contre 75 % chez les femmes. Conclusion En somme, les deux methodes utilisees sont fiables dans l’evaluation de l’âge de la majorite des sujets senegalais.

Appendicitis is the first etiology for abdominal surgical emergency. Ascariasis is the most common helminth infection in tropical countries where it is endemic. The ability of intestinal helminths to wander through the digestive system means that it can end up in the appendix lumen and lead to appendicitis by luminal obstruction. However, this presentation is still rarely described in the literature. In fact, most of the diagnoses of roundworm associated with appendicitis are made retrospectively by the discovery of its eggs on the pathological examination of an appendectomy specimen. We report the case of a 7-year-old patient living in a tropical area who consulted for acute right lower quadrant pain. The ultrasound suspected the diagnosis of appendicitis and also revealed multiple intestinal worms including one in contact with the inflamed appendix. Surgical exploration confirmed appendicitis associated with roundworm partly in the appendicular lumen through a perforation.

Stroke represents the 2nd cause of mortality and 1st cause of physical disability in the adult population. In Senegal, it represents 30% of hospitalization and 2/3 of the mortality in the department of neurology in the capital city, Dakar. Objective: To specify the types of stroke and to evaluate diagnostic delays in Senegal’s regional hospitals. Materials and Methods: This was a retrospective, cross-sectional, descriptive, multicentric study for 4 years (from 2014 to 2017) including any patient presenting a clinical suspicion with a CT scan confirmation of stroke in one of the 9 regional hospitals in Senegal with a recruitment period of 6 months per hospital. CT scans were performed with a 16 slices machine in 6 hospitals, 4 slices in 2 hospitals and 2 slices in 1 hospital. We studied the types and location of strokes, the associated signs and the time from stroke onset to admission and the time from admission to CT scan. Results: 655 patients were retained including 322 men and 333 women for an M/F ratio of 0.96. The average age was 63 years (range: 7 years, 112 years). High blood pressure was noted in 59.2% of patients and diabetes in 10.7% of patients. Strokes were ischemic in 76% of cases involving the middle cerebral artery in 73% of cases and hemorrhagic in 24%, of which 80.7% were deep localized. A mass effect was noted in 7.5% of cases, an engagement in 6.9% of cases and ventricular hemorrhage in 2.7% of cases. The delay between the onset of the deficit and admission was less than 6 hours in 10.6% of patients. The time between the onset of stroke and admission to hospital was specified in 416 patients (63.5%) of the study population, it was less than 6 hours in 10.6% of patients, between 6 hours and 24 hours for 29.3% and more than 24 hours for 60.1%. Between admission and the CT scan, the time was precise in 459 patients (70%), it was less than 6 hours in 37.9%, between 6 hours and 24 hours in 43.6 % and more than 24 hours in 18.5%. Conclusion: CT is central to the diagnosis of stroke in rural areas. However, there is a significant delay in diagnosis and management.

Kaposi’s Disease or Kaposi’s Sarcoma (SK ) is a multifocal malignant proliferation induced by viral growth factors, including interleukin 6 of human herpes virus type 8 (HHV8). We describe four forms of this disease who poses a real public health problem in East and Central Africa. The purpose of our observation was to report a rare condition in a Senegalese HIV-positive child. It was an 11-year-old girl from a region in central Senegal. She was an orphan of both parents, tested and monitored since the age of 5 for HIV infection 1. She was on the 1st line protocol. Due to a lack of support and good observance, she was referred to us at the age of 11 for follow-up in our structure in the suburbs of Dakar. The initial follow-up assessment showed a very low CD4 count and a very high viral load. Before the lack of clinical and immune-virological response, a genotypic resistance test was performed and showed immunological and virological failure. The initial development was marked by the appearance of lesions which were highly suggestive of Kaposi’s disease. She was on 2nd line treatment. The histopathological aspect of cutaneous biopsy was very suggestive of Kaposi’s disease. The subsequent course after ART and bleomycin treatment was clinically marked by regression of skin lesions. Virologically, it was marked by a fall in the viral load. Immunologically there was a gradual recovery of CD4 levels which came back to normal. Our observation demonstrates that absence of effective antiretroviral therapy for HIV increases the risk to develop Kaposi’s sarcoma.

Malignant infantile osteopetrosis is a rare genetic disease characterized by increased bone density due to osteoclastic dysfunction. We report on the case of a 3-month-old girl who was referred to our hospital by the ENT department for severe anemia in the context of bilateral choanal atresia. Clinical examination showed failure to thrive, anemia, respiratory distress, bilateral choanal atresia, and chest deformation. The abdomen was soft with large hepatosplenomegaly. We noted a lack of eye tracking, no optical-visual reflexes, and left nerve facial paralysis. The blood count showed normocytic normochromic anemia with severe thrombocytopenia. The infectious work-up and blood smears were negative. The skeleton X-ray showed diffuse bone densification of the skull, long bones, pelvis, vertebrae, and ribs. The facial bone CT confirmed membranous choanal atresia. The molecular biology search for the TCIRG1 gene mutation was not available. The patient had supportive treatment (transfusion, oral steroid, vitamin D, oxygen, nutrition). Bone marrow transplantation was indicated but not available. She died at 6 months in a context of severe anemia and bleeding. Malignant infantile osteopetrosis is rare and symptoms are nonspecific. Diagnosis should be considered in young infants presenting refractory anemia, particularly in the context of choanal atresia. Bone marrow transplantation remains the only curative treatment.

Introduction Le depistage des agents viraux VHB, VHC et VIH dans les dons de sang a ete considerablement ameliore ces dernieres annees avec l’avenement des automates bases sur la chimiluminescence. Methodes Nous avons mene une etude prospective sur 6 annees pour evaluer les performances et les limites du dosage immunologique microparticulaire par chimiluminescence des Ag-HBs, Ac anti-VHC, Ag p24/Ac anti-VIH1/2 dans les dons de sang recus au CNTS. Les dons positifs au VHB ou VHC ont ete reanalyses sur un second automate. Les dons positifs au VIH ont ete retestes par Western-Blot ou par deux techniques immunochromatographique et immuno-enzymatique. Resultats Nos resultats portent sur 163 787 donneurs de sang composes de 76,3 % de sexe masculin et 23,7 % de sexe feminin. On note une prevalence de 12,67 % pour l’Ag-HBs, 0,71 % pour l’Ac anti-VHC et 0,3 % pour l’Ag p24/Ac anti-VIH1/VIH2. Il y’avait aussi des co-infections VHB et VIH et des co-infections VHB et VHC. Sur les 775 dons reveles positifs au VIH au dosage par chimiluminescence, seuls 501 ont ete confirmes par les deux autres tests. Une discordance est notee pour les 274 dons restants qui sont soit negatif par les deux autres tests ou soit negatif pour l’un et positif pour l’autre. Conclusion Malgre leur sensibilite et specificite elevees, les techniques de dosage immunologique microparticulaire par chimiluminescence presentent des limites pouvant mener a des faux negatifs et a des faux positifs en plus du probleme de la fenetre serologique. Il s’avere necessaire ainsi d’inclure le depistage des acides nucleiques viraux comme test de confirmation dans les dons de sang pour une meilleure securite transfusionnelle.

To remind a rare disease, To emphasize the importance of patellar agenesis because it's a calling sign, To insist on the necessity to know child bony growth.We reported observations of two negro-african children's, one female and one male, who were both 7-years-old. They were referred for troubles of the walk, knee pains for the male, and for the female frequent falls and hypotonia. We have noted previous history of second degree familial consanguinity and paternal grandfather's ungueal anomalies for the female.For the female, examination showed ligamentary hyperlaxity, anterior flattening and lateral dimple of the knee, so varied skeletal defects. Skeletal radiographies displayed absence of the patella, "console like" aspect of the superior tibial metaphysis. At the male, examination is normal. Standard radiographies showed semilunar opacities and tomodensitometry showed presence of a tissular formation who looks like the patella. Aplasia of the patellar apparatus is evocated for the female, even though for the male, the diagnosis of hypoplasia seems more probable.Absence of patella is rare. It can be transient and patellar nucleus appears lately. It can be permanent and in this case, it is isolated whether associated with other osseous malformations. Interest of such observations is in its rarity and its functional impact related to the biomechanical importance of the patella.

The encephaloceles belong to dysraphic state abnormalities. Publications on this issue are rare and sparse in Africa. The aim of our study is to describe clinical patterns of occipital encephaloceles, and emphasize on surgery. We collect retrospectively a population of 16 patients. Cranial Ultrasound Echographia has been done for all of them. Only 3 patients got brain CT scan. Medium age was 2 months. The sex ratio was coted 1. The consanguinity was noted in 37% of the cases. The pedicular aspects were more frequent. With neuroimaging studies the diagnosis was reached everytime. It showed hydrocephalus on 3 patients. 15 patients have been operated. One dead before going to surgery. The outcome was good for 13 patients (81%). But 3 patients (18%) deaded, and among them, 2 deaded during post surgery period. A better clinical evaluation showed be done using MRI. The control of epidemiology of these conditions depend on the improvement of the quality of eating in particularly in women bearing child, and performing a genetic counseling.

Infantile cortical hyperostosis (ICH) or Caffey-Silverman disease is affection that attained skeleton most frequently flat bones, contiguous fasciae and muscles. We reported the case of a 3 months old female infant of Mauritanian origin, referred for recurrent osteitis of the left clavicle. The present complaints are incessant snivelling and functional disability of the left upper limb. Examination showed clavicular and mandibular swelling, without fever. Biological check-up showed inflammatory signs. Radiographies showed cortical thickening of the left clavicle and mandible. Interest of such an observation is in the rarity of this affection, its originality as for the striking age limitation, in the disconcerting but suggestive symptomatology, at least in the classical sites and in the possibility of its antenatal diagnosis.

Introduction Les mucoceles du sinus frontal realisent des formations pseudokystiques, lentement evolutives. Elles sont benignes mais peuvent evoluer vers l\'endocrane. Objectif L\'objectif de notre etude est de decrire les aspects cliniques,paracliniques et therapeutiques d\'un telle affection. Patients et methodes Il s\'agit d\'une serie retrospective de six patients colligee de Janvier 1994 a Decembre 2003. Tous les patients ont beneficie d\'un examen clinique et d\'explorations radiologiques : radiographie standard et tomodensitometrie. Une voie d\'abord neurochirurgicale a ete effectuee dans tous les cas. Le diagnostic est confirme par un examen histologique. Le suivi est assuree pour une duree minimale de 6 mois. Resultat Il s\'agit de trois hommes et trois femmes. L\'âge moyen est de 33 ans. Le signe clinique le plus frequent est la tumefaction frontale progressive. Le delai de consultation varie de 1 a 6 ans. Aucun deficit neurologique n\'est note. Le signe radiologique standard le plus frequent est la lyse de la paroi sinusale. La tomodensitometrie montre une extension intra cranienne dans 2 cas. Une voie d\'abord frontale a permis une exerese complete dans tous les cas. Conclusion Malgre leur benignite,les mucoceles du sinus frontal peuvent presenter d\'importantes extensions intracrâniennes sources de souffrance cerebrale. Le diagnostic tardif explique l\'etendue des lesions. Introduction Frontal sinus mucoceles are benign mass lesions developing slowly. They can involve intra cranial areas et make brain tissues compression. Objective The aim of our work is to describe clinical, radiological and therapeutical aspects of such affection. Patients and methods Six patients are received from 1993 to 2003. Three Xrays examination and three CT scans are performed. All patients are operated by neurosurgical approach. Diagnosis is confirmed by histological examination. Results The main clinical sign is frontal tumefaction growing during one till six years. None neurological deficit is found. Radiological examinations show lytic frontal sinus wall destruction with intracranial involvement in two cases. Bilateral approach is performed and therefore permit complete mass lesion removal. Conclusion Frontal sinus mucoceles can induce important bone destruction because in developing countries, diagnosis is made lately. Keywords : Afrique, Mucocele, Senegal, Sinus frontal, Frontal sinus tumors, Mucoceles African Journal of Neurological Sciences Vol. 24 (2) 2005: pp. 40-47

Introduction L\'hematome sous dural est une complication observee lors du traitement chirurgical de l\'hydrocephalie. Avant l\'avenement de la tomodensitometrie a Dakar, une incidence de 0,8 % etait trouvee. Objectif L\'objectif de notre travail est de reevaluer cette incidence a la lumiere de cet examen et de determiner les divers facteurs etiologiques. Patients et Methode Nos patients ont ete operes par derivation ventriculo-peritoneale et sont âges de 8 a 30 ans au moment du diagnostic. Quatre sont de sexe feminin. Le signe le plus frequent est l\'hypertension intra-cranienne. La tomodensitometrie a etabli le diagnostic dans tous les cas. Elle montrait dans 4 cas, un hematome unilateral et dans deux cas, une forme bilaterale. D\'importantes calcifications sont retrouvees dans deux cas. Cinq patients ont ete operes et nous notons deux deces. Les valves utilisees sont a debit de drainage fixe. Resultat Il existe une augmentation de l\'incidence par rapport a notre premiere serie datant de 12 ans. Par rapport aux autres systemes de drainage, nous ne notons pas de difference significative. Aucun facteur etiologique determinant n\'est retrouve. Conclusion Cette complication pouvant pauci-symptomatique, la realisation d\'examens tomodensitometriques systematiques permettrait de constater une plus grande frequence de cette complication Introduction Subdural hematoma is a complication which can occur seen after setting a shunt for hydrocephalus. Prior to CT scan installation in Dakar, the incidence was 0,8%. Objective Our aim is to consider twelve years later this complication and others causal factors. Six patients were observed, between 8 and 30 years. Four of them were female. The main sign is increased intra cranial pressure. CT scan shows the hematoma : two bilateral and two calcified.Two patients deceased after surgical treatment. Results The frequency is not due to shunt type or any specific cause. Conclusion The complication may occur without clinical complain and CT scan for all surgically treated patient is mandatory Keywords : Afrique, derivation ventriculo-peritoneal, hematome sous dural, hydrocephalie, valve, Senegal, Africa, subdural hematoma, hydrocephalus, shunt, Senegal African Journal of Neurological Sciences Vol. 24 (2) 2005: pp. 28-32

Patients with suspected dissection of the thoracic aorta require immediate diagnostic evaluation so that urgent therapeutic interventions can begin. Two women with suspected aortic dissection and one man with abdominal aortic aneurysm underwent color-flow Doppler echocardiography and CT angiography with multiplanar reconstructions. Spiral CT showed ascending aortic dissection (type A Stanford) in two cases and descending aortic dissection (type B Stanford) in one case. It also access the visualization of the intimal flap, the extent of dissection, the size of the aorta, and the presence of pericardial fluid. CT angiography is an accurate diagnostic procedure for patients with suspected aortic dissection and possesses several advantages over other modalities such as transthoracic echocardiography, transesophageal echocardiography and aortography.

The Objectives of this study were to Report a rare malformation and to try to understand the embryological origin of such lesion. We reported the case of an eight-month-old female infant, without any particular past medical history, who was refered for seizures and vomiting. The examination revealed normal anthropometric constants, a soft painless and renitent tumefaction of the vertex and a psychomotor delay. Skull x-ray showed a parietal lacuna opposite to an opacity. Ultrasound scan showed an encephalocystocele communicating with dilated ventricles. CT x-ray revealed a single ventricle with an important back and upper extension, which evokes a cystic formation of the centre line. The existence of this cystic formation suppose an agenesis of diencephalic and telencephalic structures notably commissural. Interest of such observation is in its rarity, its complexity, the possibility of its antenatal diagnosis and in the etiopathogenic discussions that she gives rise to.

Authors report the case of 3 years old boy. He represented a severe head injury with dura mater damage and skull fracture. He has been operated and few years later, he present a vault tumefaction. CT scan show a very large bone defect, a cerebral and ventricular hernia. Mecanism and causal factors are discussed.

A retrospective study of 9 cases of fronto-ethmoïdal encephaloceles is reported. Cases have been gathered from the files of Dakar University Neurosurgical Unit. Fronto-ethmoïdal encephaloceles were about 9.8% of all encephaloceles. In all the cases the exit hole from the anterior cranial fossa is at the site of the foramen caecum. The location of the tumor was fronto-nasal in seven patients and naso-ethmoïdal in two. The cranio-facial deformity consisted of increase of local volume and a lateral displacement of medial canthus in six cases, a down ward drift of the tip of the nose in two cases and one case of orbital hypertelorism. Eight cases were meningo-encephaloceles and the last a meningo-encephocystocele. Diola was the most ethnic group involved. All patients have been operated by a simple neurosurgical procedure without obstruction of the cranial defect nor bony displacement. In five cases mental and aesthetic results were good when operation was done during the first year of live. The authors stress early surgical treatment for fronto-ethmoïdal encephaloceles.

The authors studied mammographic features of 25 patients with malignant breast disease. 24 of them had ultrasonographic (US) exploration. The study appreciates epidemiological, mammographic and US aspects; It also appreciates the correlation between images and histology. The mean age is 40. Six women (26%) had family history cancer. The mean reason of the exploration is a mass in 76%. At mammography, contours of cancerous opacities are irregular in 56%, regular in 16%. In 20%, the cancer showed no opacity. At US, we find a lack that appears irregular in 48%, regular in 24%, without traduction in 4%, non precised in 24%. Mammography sensitivity was 80%, false negative rate 28% and false positive rate 8% against respectively 96%, 32% et 12% for echography. This study shows that US is more sensitive but less specific than mammography. However, we recommend the use of mammography and echography together because in Senegal, cancer happens at an earlier age at with breast is easier to analyze at US.

In this paper, one case of syndrome of caudal suppression associated with a syndrome of Klippel Feil is discussed. It concerned a 14 years old boy, born form a diabetic mother with congenital abnormalities such as: urinary incontinence, facial dysmorphia, a short neck, an arachnodactylia, a lumbar kyphosis, a permanent flexion of the knee, a kalipe cavus, the spine, a partial agenesis of the third and fourth lumbar vertebrae a total agenesis of the fifth and sacrum; This syndrome is infrequent and the pathophysiological mechanisms are still under discussion and no therapeutic strategy is proposed. This case offers an opportunity to the authors to make review of the medical literature on this subject. They emphasized on the interest to look for a vertebro-medullary malformation every time a child comes to us with walking problem or enuresia, this fact should be enforced when mother is diabetic.

Objectifs Etudier les aspects cliniques, biologiques et radiologiques des mycetomes, infection bacterienne ou parasitaire pseudo-tumorale et endemique au Senegal. Materiels et methodes Etude retrospective sur 68 hommes et 24 femmes, presentant des mycetomes des pieds cliniquement et ou mycologiquement prouves. Etude des donnees cliniques, biologiques, radiographiques et TDM. Resultats L’âge moyen etait de 37 ans. Les principales localisations etaient dorsoplantaire dans 35 cas, dorsale dans 20 cas, madura dans 18 cas, plantaire dans 15 cas. L’aspect clinique etait une tumefaction diffuse polyfistulisee dans 77 cas, nodulaire encapsulee dans 4 cas, seche hypertrophique dans 4 cas. Le grain emis etait noir dans 72 cas (21 Madurella mycetomis, 8 Leptospheria senegalensis), blanc dans 10 cas (5 Actinomadura madurae, 1 Alesheria boydii, 1 Madurella mycetomis, 1 Streptomyces somaliensis), rouge dans 4 cas (4 Actinomadura pelletieri), jaune dans 1 cas (Streptomyces somaliensis). L’imagerie retrouvait des signes d’osteite dans 57 cas principalement tarso-metatarsiennes : - lesions lytiques : erosions et multigeodes de grande taille (n = 29) pour Madurella mycetomis, plus petites (n = 7) pour Leptospheria senegalensis et lesions articulaires dislocantes dans les etiologies fongiques ; - lesions osteocondensantes parfois lytiques microgeodiques et periostites (n = 9) et lesions articulaires fusionnantes essentiellement dans les etiologies bacteriennes. Conclusion L’imagerie permet d’affirmer une atteinte osseuse et d’orienter vers une etiologie fongique ou bacterienne.