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Conjoined twins are a rare outcome of conception associated with numerous anomalies involving multiple organ systems. Musculoskeletal abnormalities like vertebral anomalies, sacral agenesis, foot deformities and hip dysplasia have been described in literature. We describe two cases of pyopagus twins with congenital talipes equinovarus and congenital vertical talus deformity which have not been described previously in this type of conjoined twins. The orthopaedist should look actively for such deformities in this patient population and be wary of the difficulties associated with their management. [ABSTRACT FROM AUTHOR]

Melanotic neuroectodermal tumour of infancy (MNTI) is an uncommon tumour, predominantly occurring in head and neck, mostly maxilla, but also in skull and mandible. Although a benign lesion, it is known to recur in 15%–27% of cases, and rarely, may undergo malignant transformation. We present a case of a 5-monthold female patient, who presented with a gradually progressive swelling in the right thigh. On imaging, an osteolytic lesion was seen, involving the metadiaphysis of shaft of right femur. A biopsy was performed, on which diagnosis of MNTI was made. MNTI is rarely seen in extremities. To the best of our knowledge, only six cases have been reported in femur, the present case being the seventh. The tumour showed spontaneous regression on follow-up in our patient, which has rarely been described. A knowledge of characteristic morphology and immunohistochemistry is the key to differentiate it from other tumours. [ABSTRACT FROM AUTHOR]

Bizarre parosteal osteochondromatous proliferation (BPOP; also called Nora's lesion) is a benign surface osteocartilaginous lesion, which is infrequently reported in world literature. The condition is classically described in the short tubular bones of hands and feet in the second and third decades of life. We present a case report of BPOP of the middle phalanx of middle finger in a 4-year-old girl. The child underwent a wide excision and remained asymptomatic at 2.5 years of follow-up. Our case report highlights the importance of suspecting Nora's lesion in a child. It also helps in delineating a differential diagnosis and discusses the management principles of this rare osteocartilaginous lesion. [ABSTRACT FROM AUTHOR]

Multifocal osteoid osteoma of the bone is extremely rare. We report a 25-year-old man who presented with pain in the left leg since 11 months which was partially relieved by over-the-counter analgesics. Radiograph demonstrated two lytic lesions with surrounding sclerosis along the anterior cortex of the left tibia. Three-phase Tc 99m bone and CT scans confirmed the diagnosis of multifocal osteoid osteoma. The patient underwent surgical excision followed by protected weight bearing. The patient was asymptomatic at 6 months postoperatively. Multifocal osteoid osteoma needs to be considered in the differential diagnosis of multiple lytic lesions in the bone. [ABSTRACT FROM AUTHOR]