M. Latifi

Foreign Body Granuloma: A Diagnosis Not to Forget

Penetrating wounds of the foot are not uncommon. Many are caused by thorns or by fragments of wood that are retained in the foot, creating a foreign-body granuloma. The differential diagnosis for bony reaction to an unrecognised organic foreign body includes osteoid osteoma, chronic and acute osteomyelitis, tuberculosis granuloma, bone cyst, aneurysmal bone cyst, cortical fibrous defect, and neoplasm. We report the case of a boy suffering from a thorn inducing a lytic lesion of the fifth metatarsal that demonstrates the diagnosis difficulties of foreign body granuloma.

L’amputation des doigts par morsure de serpent : à propos de trois cas

The amputation of the finger complicating an ophidian bite is rare. It is due to virulence of the venom, its concentration in a small volume of tissue and use of a tourniquet. Support of the victim seeks to save his life and function of his(her) hand. Antivenin immunotherapy is the only specific treatment for ophidian envenimation. It is indicated in case of general signs showing a serious bite, but also if local signs could lead to loss of limb function. The authors report three cases of snakebite complicated by amputation of a finger.

Cas cliniqueTumeur ténosynoviale à cellules géantes diffuse du poignet révélée par un syndrome du canal carpien : à propos d’un casDiffuse tenosenovial giant cell tumor of the wrist revealed by carpal tunnel syndrome: Report of a case

Giant cell tumour of tendon sheath is a benign proliferative lesion of synovial origin that may affect the joints, bursae and tendon sheaths. It is the second most common soft tissue tumor of the hand after ganglion cyst. The localised (nodular) form is the most common. However, the less-common diffuse-type giant cell tumour is usually located in the peri-articular soft tissue. The authors report the case of a giant cell tumor of the tendon sheath arising from the carpal tunnel of the wrist in a 42-year-old woman. The patient presented a mild carpal tunnel syndrome and a mid-palmar swelling. We present an unusual localization of giant cell tumor of the tendon sheath, causing carpal tunnel syndrome.

Tumeur ténosynoviale à cellules géantes diffuse du poignet révélée par un syndrome du canal carpien : à propos d’un cas

Giant cell tumour of tendon sheath is a benign proliferative lesion of synovial origin that may affect the joints, bursae and tendon sheaths. It is the second most common soft tissue tumor of the hand after ganglion cyst. The localised (nodular) form is the most common. However, the less-common diffuse-type giant cell tumour is usually located in the peri-articular soft tissue. The authors report the case of a giant cell tumor of the tendon sheath arising from the carpal tunnel of the wrist in a 42-year-old woman. The patient presented a mild carpal tunnel syndrome and a mid-palmar swelling. We present an unusual localization of giant cell tumor of the tendon sheath, causing carpal tunnel syndrome.

Le mycétome tumoral du pied

RésuméLes auteurs rapportent l’observation d’un patient âgé de 56 ans qui consulte pour une tumeur du pied droit évoluant depuis 20 ans. L’examen retrouve une masse bourgeonnante, polyfistulisée, mesurant 10–20 cm et intéressant la face dorsale du pied et englobant la plante. La radiographie du pied retrouve une lyse osseuse des troisième, quatrième et cinquième métatarsiens. L’examen histologique retrouve un mycétome actinomycosique du pied. La lésion s’est compliquée d’une gangrène septique du pied qui a nécessité une amputation de celui-ci. Les mycétomes du pied sont des maladies infectieuses chroniques et endémiques dans les pays tropicaux. Ils sont rares dans notre contexte rendant le diagnostic difficile. Le traitement est médical, associé à une excision chirurgicale radicale des tissus atteints. Dans les cas évolués, ces lésions engagent le pronostic fonctionnel du membre et parfois le pronostic vital du patient.AbstractMycetoma is a rare andlittle-knownpathology in Morocco. The authors present the case of a56-year-oldpatient with a tumor of the right foot that had developed over 20 years. A pathological examination revealed an actinomycosic mycetoma of the foot. The injury was complicated by septic gangrene of the foot, requiring amputation. Mycetoma of the foot is a chronic and endemic infectious disease in tropical countries. However, it is rare in our context, making diagnosis difficult. The medical treatment involves radical surgical excision of diseased tissue. Mycetoma of the foot is a potentially fatal disease.

Unusual Presentation of a Rare Tumor of the Dorsal Surface of the Foot

Calcifying aponeurotic fibroma (CAF) was originally described by Keasbey in 1953 as juvenile aponeurotic fibroma, most commonly occurring in the palms of the hands and soles of the feet in children and adolescents. It usually presents as a firm, painless mass without preceding trauma. We report a case of this rare condition with an unusual presentation in a 60-year-old woman affecting the dorsal surface of the foot. It is a relatively benign condition with a good prognosis following complete surgical excision. It may have a slightly increased incidence in males. The accurate diagnosis is based only on histology but it is essential to differentiate it from other sinister lesions such as fibrosarcoma that may lead to amputation.

Fixateur d’Hoffman dans les fractures de la cheville

Through a retrospective study, we report a series of 26 cases of complex fractures of the ankle treated by Hoffman external fixator with metatarsotibial montage. This study has been realized during three years at the traumatology and orthopedics department at UHC Mohammed VI. The fractures concerned 18 men and 8 women that the mean age was 41,88 years old, they are due particularly to highway accidents in 61,2% of the cases. We have 53,49% pilon tibial fractures, 42,94% bimalleolar fractures and 3,57% talus fractures. The open fractures were classified according Cauhoix and Duparc’s classification: 15% were type I, 55% were type II and 30% were type III. The consolidation was about 92 days on average. The complications consisted respectively in 3 deep infections, 2 superficial infections, 2 algodystrophy syndrome, one aseptic pseudarthrosis and one surgical reintervention. The analysis of the anatomic and functional results showed 62,5% of good results, 31,25% of average results and 6,25% of bad results.

Ostéome ostéoïde de l’os naviculaire tarsien: à propos d’un cas et revue de la littérature

RésuméL’ostéome ostéoïde est une tumeur bénigne, siégeant essentiellement au niveau des os longs. Sa localisation au niveau des os courts est exceptionnelle. Nous rapportons un cas d’ostéome ostéoïde de l’os naviculaire, chez un patient âgé de 46 ans qui présentait des douleurs du pied droit évoluant depuis un an. Ces douleurs étaient calmées par les AINS mais récidivaient à l’arrêt de leurs prises. Les radiographies standard ainsi que la tomodensitométrie ne retrouvaient pas de lésion. Une biopsie a été faite sans spécificité. Une IRM a été demandée. Celle-ci a mis en évidence une image en hyposignal circonscrite en T1 et hypersignal en T2. La prise en charge a consisté en un évidement de l’os naviculaire avec conservation des surfaces articulaires et interposition d’un greffon corticospongieux. Les suites ont été simples avec disparition des douleurs, sans récidive à 33 mois, et intégration du greffon. Le diagnostic a été confirmé par étude histopathologique.AbstractOsteoid osteoma is a benign tumour that usually affects the long bones. Its localization to the tarsal navicular bone of the foot is rare. We report a case of a 46-year-old man with an 18-month history of persistent foot pain whose diagnosis was difficult and established late because of a clinical presentation resembling arthritis. The patient underwent an en bloc excision of the nidus, reporting immediate pain relief and experiencing no recurrence of the lesion or symptoms 33 months after the procedure.

Ostéonécrose aseptique de la tête du fémur dans la thalassémie mineure: á propos d'un cas.

We report a case of aseptic necrosis of the femoral head in a 14-year-old black adolescent with thalassemia minor disclosed by physical examination and blood tests. No other anomaly could be identified. Despite the very probably secondary nature of the aseptic osteonecrosis of the femoral head and the absence of any other etiology, it is highly difficult to demonstrate the causal effect of thalassemia minor. We reviewed the literature and discuss the pathogenesis of this association.