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Osteosarcoma (OS) is the most common primary non hematopoietic malignant tumor of bone with a strict histologic definition: the presence of unequivocal osteoid produced by neoplastic cells. Rare variants displaying low-grade histological features have been described; among which chondromyxoid fibroma-like (CMF-OS) is the rarest. However, despite its bland morphology; CMF-like OS has an aggressive clinical behavior and a poor prognosis. To the best of our knowledge, only 3 cases of CMF-OS have been previously reported in children. Because of its atypicality and scarcity; misdiagnosis is more likely to occur. Herein we describe a new case of CMF-OS in a 13 years old girl with fatal outcome. Diagnosis was based on focal malignant bone formation and correlation with imaging studies. The aim of the present case presentation is to raise awareness of this rare entity and to highlight the challenging diagnosis

Pseudotumoral calcinosis is a rare benign tumor, characterized by deep calcium deposition in peri-articular soft tissues. A numerous list of calcium deposit diseases exists making the calcinosis diagnosis very challenging. There are three principal forms or etiologies; primary or idiopathic forms followed by secondary forms due to chronic renal failure or hyperparathyroidism, then genetic forms such as Hyperphosphatemic Familial Tumoral Calcinosis (HFTC). We report a case of 14-year-old boy with primary tumoral calcinosis of the right hip. Total mass resection was performed without any recurrence at one-year follow-up.

Exostosis or osteochondromas are benign bone tumors frequently.These benign tumors may be symptomatic or be manifested on the occasion of a complication. We report the case of a child boy 1O years, admitted to our training multiple exostosis, with a location iliopubic left that proved by painful induration left of the base of the penis. Induration the increasing volume, it bothered the child during urination. Conventional radiography and CT were in favor of a pedunculated osteochondroma of the left iliac ramus compressing the urethra. The child underwent surgical tumor resection and pathological examination confirmed the diagnosis of osteochondroma. The evolution was good with disappearance of urinary symptoms down two years without recurrence. Keywords: Exostosis, Osteochondroma, Dysuria, Iliopubic, Child

La tuberculose osseuse est une maladie infectieuse qui constitue un véritable problème de santé publique dans les pays en voie de développement où elle sévit de manière endémique. L'atteinte ostéo-articulaire représente 1 à 5% des cas de tuberculose toutes localisations confondues, l'atteinte de l'épaule reste très rare et représente 1 à 2% des localisations ostéo-articulaires. Nous présentons ici un nouveau cas exceptionnel d'une infection tuberculeuse de l'omoplate, atteignant le corps de l'omoplate. La tuberculose est encore un diagnostic différentiel important des maladies rares ou chroniques des os, notamment tumorales. Le diagnostic a été redressé par l'étude anatomopathologique.

Le kyste osseux anévrismal est une lésion agressive et destructrice, mais bénigne, des os longs, de la colonne vertébrale ou du bassin, touchant principalement les enfants et les jeunes adultes. Il s’agit cependant d’une véritable tumeur rare. Nous rapportons un cas d’un garçon de 8 ans,présentant une localisation très rare de kyste anévrismal, claviculaire, qui s'est initialement présenté pour une fracture sur os pathologique soit une lésion kystique bénigne. L'enfant a bénéficié d'un traitement radical avec résection complète du kyste situé au niveau de la clavicule droite avec envoi de la pièce opératoire pour étude anatomo-pathologique, confirmant notre diagnostic. L'évolution a été marquée par l'absence de récidive et un bon remodelage osseux sur le plan radiologique. Le traitement radical par résection semble permettre d'éviter la récidive. A travers notre travail, nous voulons mettre le point sur cette affection orthopédique rare en comparant nos résultats avec ceux de la littérature mondiale.

Resume Introduction. – Les auteurs rapportent une experience de 21 ans, a travers une serie de 106 enfants atteints de localisations osteoarticulaires de la tuberculose (le mal de Pott est exclu de cette etude). Patients et resultats. – Il s’agit de 55 garcons et 51 filles, d’âge moyen de 8 ans. La hanche et le genou representent 63 % des localisations tuberculeuses dans cette serie, 32 localisations viscerales associees ont ete recensees. Le delai moyen de consultation est de 10 mois ce qui explique un taux de sequelles aux alentours de 22 %, a type d’ankylose articulaire et d’inegalite de longueur des membres. Conclusion. – La tuberculose osteo-articulaire (TOA), represente donc une source d’handicap fonctionnel qui doit etre reconnue et traitee precocement surtout en milieu pediatrique ou un traitement bien conduit peut amener une disparition complete des lesions (14 cas de notre serie).

The authors reviewed a series of 36 progressive lengthenings of the lower member by callotasis (22 femur and 14 tibia) in 33 patients with an inequality of length of the lower member (ILLM). Median age was 13 years; etiology was dominated by infection, congenital defects, and trauma. The lengthening procedure was completed in 26 children; it was necessary to abandon seven lengthening attempts. Median lengthening achieved was 45 (range 30–100) mm. Complications were frequent, with 66 during the different stages (184%). Most were benign (40); seven were determined to be grave, requiring abandonment of the lengthening; while 17 were judged as serious and required an unforeseen supplementary general anesthesia. Upon review of these results, it appears that progressive lengthening is an attractive technique with considerable benefits. However, management is not simple and complications are frequent, requiring close collaboration between the nursing team, the child, and the child's parents. For patient and family, the psychological benefits of this procedure are considerable.

Congenital radioulnar synostosis is an uncommon condition, only 400 cases have been reported in the world literature. Often bilateral, it can be recognized from birth by a clinical examination if it is attentive (examination of the prono-supination of the two elbows). It is in fact often discovered later, especially in unilateral forms, in children of school age. The proximal congenital radioulnar synostosis often results in functional, cosmetic limitations of the upper limb especially in the bilateral forms. Rotational osteotomy through the synostosis site is the usual procedure. The techniques and sites envisaged for this surgery are numerous, with multiple difficulties, risks and possible complications. We propose the observation of an eight-year-old boy with a symptomatic form of proximal radioulnar synostosis. The surgical treatment consisted of a resection of the synostosis withrotational transversalosteotomy of the two bones of the forearm completed by a plaster in neutral position. Clinical results, evaluated at an average of twelve months postoperatively, were found to be satisfactorily on aesthetic and functional levels. The aim of our work is to highlight our simple and reliable surgical procedure of the osteotomy of the synostosis maintained by spindles, allowing the functional improvement of the movements of the forearm of our child and thus a normal life.

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).