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Soft tissue osteochondromas are rare lesions, with a misleading radiology, that can present diagnostic dilemma.We report the case of 16-year-old girl who presented an anterior swelling in his left elbow, slightly painful on palpation, with no signs of inflammation. Elbow mobility was normal. Standard radiographs showed a globular calcified mass. CT scan revealed a well-defined lobulated soft tissue mass with extensive flaky calcification. Magnetic resonance imaging (MRI) showed lobulated and intermuscular non-enhancing mass. The lesion had a low heterogeneous signal on T1 images, and a high heterogeneous signal on T2 FAT-SAT images, with low signal areas suggesting calcifications. There was no continuity to the adjacent ulna and radius. The patient first underwent image-guided core needle biopsy and histological examination concluded to chondroma. The tumour was then resected by anterior approach and the final histological diagnosis was osteochondroma of soft tissue.A diagnosis of extraskeletal osteochondroma should be considered when an ossified mass is localized in the soft tissue particularly on the elbow. Excision is the treatment of choice when the function is reduced and the nature of the tumour remain uncertain.Orthopedic surgeons should know about elbow localization of osteochondromas to help in accurate diagnosis and management of the tumour, to avoid overtreatment.

Resume La pathologie sportive de l’enfant et de l’adolescent a pris, ces dernieres annees, une importance considerable du fait de la pratique du sport a des âges de plus en plus jeunes et a des niveaux de plus en plus eleves. A cause de l’immaturite musculo-squelettique, des entites particulieres a l’enfant ont pu etre individualisees dont la plus frequente est representee par les arrachements apophysaires. D’autres entites, a savoir les arrachements diaphysaires, connues surtout chez l’adulte, peuvent se voir chez l’enfant. A travers deux observations pediatriques d’arrachements musculaires diaphysaires des muscles adducteurs, lesion rare et souvent meconnue, nous allons definir les caracteristiques cliniques, radiologiques et therapeutiques de cette lesion.

Resume Le syndrome de Protee est une maladie hamartomateuse congenitale rare responsable de deformations orthopediques frequentes. Le resultat et les complications du traitement chirurgical de ces deformations sont mal connus vu la rarete des cas rapportes. Les auteurs rapportent le cas d’une evolution defavorable d’une osteotomie tibiale valgisante proximale chez une patiente de six ans porteuse d’un syndrome de Protee. L’evolution s’est faite vers une necrose profonde etendue de la voie d’abord avec mise a nu de l’os, necessitant une excision chirurgicale, une antibiotherapie ainsi qu’une cicatrisation dirigee. Il y a eu recidive de la deformation orthopedique au recul de 1 an. La possibilite de complication grave et de recidive en cas d’abord chirurgical pour intervention orthopedique chez les patients porteurs de syndrome de Protee doit etre connue. Ces complications doivent etre prises en compte dans le choix de la technique chirurgicale correctrice et peuvent faire preferer les techniques d’epiphysiodese aux osteotomies.

The aim of this study was to evaluate the results of two antibiotic therapy protocols for osteomyelitis with different durations of intravenous treatment. This was a prospective randomized study of children treated for acute hematogenous osteomyelitis. Patients in group 1 (G1) received 7 days of intravenous antibiotics, whereas patients in group 2 (G2) received 14 days. Treatment was deemed effective if there were no signs of chronic osteomyelitis at the last follow-up. Fifty-three patients were included in the study (G1=27, G2=26). After a mean follow-up of 11.5 months, none of the patients in either group showed signs of chronic osteomyelitis. In conclusion, a shortened treatment of 7 days of intravenous antibiotic therapy is as effective as a longer treatment.

Hidradenoma is a rare benign tumor that develops of the eccrine sweat glands. We report here two cases of benign giant hidradenoma with a clear cell variant in one case and nodular in the other. The tumor was localized on the forearm in a patient aged 6 years and in the foot in a 14-year-old child. An excisional biopsy was performed in both patients. Evolution was marked by a good outcome without recurrence. We try through this paper to review an uncommon tumor which his eccrine origin is controversial and which biological behavior was badly known.

La maltraitance physique des enfants ou le syndrome des enfants battus est responsable de plus de 75.000 décès par an en France. Ce problème de santé publique reste sous diagnostiqué en Tunisie et dans le monde. Le chemin a été laborieux pour la reconnaissance du syndrome des enfants battus dans certaines sociétés même occidentales. Nous avons voulus exposer ce problème aux praticiens afin qu'il soit mieux diagnostiqué et pris en charge. La maltraitance physique des enfants est appelée à tort syndrome de Silverman qui ne regroupe en fait que les lésions squelettiques chez ces enfants tels que les fractures. Mots clés: Fracture, maltraitance, enfant, neuro-radiologie.The Pan African Medical Journal 2016;24

Dysplasia epiphysealis hemimelica (DEH), also known as Trevor's disease, is a rare congenital skeletal developmental disorder in childhood. It is characterized by an asymmetric osteocartilaginous overgrowth arising from epiphyses or epiphyseal equivalents. Lesions have hemimelic topography, usually occur in the lower limbs, most commonly in the ankle and the knee and affect either the medial or lateral part of one epiphysis. Objective The purpose of this study is to describe the imaging features of DEH by reporting four cases. Materials and methods We present four cases of DEH in one female and three males aged between 7 and 15 years. Lower limb is involved in all cases and patients suffer from pain, limited function and deformity. Radiographs and CT findings were reviewed. All patients were treated by surgical excision. Results Plain X-ray revealed in all cases an irregular ossification arising from the affected epiphysis. The CT scan revealed an irregular fragmented osteocartilaginous mass involved from the epiphysis, with enlargement of epiphyses and intra-articular extension. Conclusion The early diagnosis and treatment of DEH is necessary in preventing articular function, CT assists in defining the anatomic relationship between the mass and its parent epiphysis and in evaluating the condition of the articular cartilage and soft tissue. The distinct clinical and radiographic features should enable to differentiate the osteochondroma and the DHE.

Thirty-one hips in 27 young girls, treated for developmental dysplasia of the hip in the authors' institute since 2003, showed persistent radiographic evidence of residual acetabular dysplasia. These hips were registered as candidates for pelvic osteotomy. A prospective study was conducted and these hips were evaluated by magnetic resonance imaging (MRI); the average age of the patients was 5 years. MRI measurement of acetabular angle and acetabular head index in 2 different landmarks (bone and cartilage) was performed. The results were correlated with plain radiographic film evolution. MRI studies revealed sufficient cartilaginous acetabular coverage in 27 hips, cartilaginous acetabular dysplasia in 2 hips, and short acetabulum in 2 others. The 27 hips with thick cartilage of the acetabular roof were subsequently followed up by plain radiographs. The average follow-up period was 2.1 years. The authors observed a spontaneous progressive ossification of the cartilaginous acetabular roof in all the 27 cases. In 4 cases, the correction of the acetabular angle was complete. They concluded that MRI promotes more accurate selection of patients for pelvic osteotomy and aids in the choice of the most appropriate type of osteotomy. Clinical imaging examples are presented and need to be further evaluated.

Resume L’osteochondrite dissequante est une affection touchant essentiellement le condyle femoral medial. Nous rapportons ici deux localisations rares au niveau du genou, une tibiale proximale et une rotulienne. Il s’agissait de deux garcons âges de 14 ans qui consultaient pour des gonalgies evoluant depuis, respectivement, quatre et trois mois sans notion de traumatisme avec des episodes de blocage articulaire. La radiographie standard et l’IRM ont conclu a une osteochondrite dissequante, respectivement, du plateau tibial lateral associee a un menisque discoide fissure et de la rotule compliquee d’une liberation intra-articulaire du fragment osteochondral. Une arthroscopie a ete faite pour les deux patients avec une regularisation du menisque discoide pour le premier et une ablation du fragment osteochondral pour l’autre. A travers ces deux observations, nous discutons essentiellement la pathogenie de cette affection dans ces localisations particulieres.

Resume Nous rapportons une serie de 26 cas d’osteomyelite du calcaneum, afin d’etudier les particularites cliniques et paracliniques de cette localisation rare. Le tableau clinique n’etait pas specifique. La temperature n’etait superieure a 38,5 °C que dans 45 % des cas. La symptomatologie etait celle d’un syndrome douloureux et febrile de l’arriere-pied avec une impotence fonctionnelle du membre. La douleur etait a distance du calcaneum, ce qui a fait errer le diagnostic dans six cas. Le syndrome inflammatoire biologique n’etait pas constant. Une leucocytose superieure a 10 000 par millilitre n’a ete notee que dans 61 % des cas. Le diagnostic de l’osteomyelite du calcaneum a ete retenu sur la radiographie standard, en montrant une geode au niveau de calcaneum dans 12 cas, sur l’echographie, realisee chez 19 malades et qui a montre six decollements sous-periostes au niveau de calcaneum, trois collections au niveau de l’arriere-pied et quatre epaississements des parties molles. La scintigraphie osseuse, realisee dans un cas, a montre une hyperfixation en regard du calcaneum. L’IRM, realisee chez un patient, a pu mettre en evidence une anomalie de signal au niveau de calcaneum sous forme d’un hypersignal T2 et hyposignal T1, avec la presence d’un abces sous-perioste. L’enquete bacteriologique etait positive dans 53 % des cas. Le traitement etait medical dans tous les cas, 23 enfants ont du subir un acte chirurgical. Nos resultats ont ete etudies avec un recul moyen de deux ans avec des extremes de un an a sept ans. Dix-neuf malades (73 %) n’ont garde aucune sequelle. Sept malades (27 %) ont presente des mauvais resultats avec limitation importante de la mobilite au niveau de l’arriere-pied et une ankylose de la cheville. On a note sept passages a la chronicite avec fistules, dont une reste productive au dernier recul. Les mauvais resultats ont ete observes chez des patients traites tardivement avec un delai moyen de consultation de 17 jours. Six mauvais resultats sur sept associent des arthrites a l’atteinte du calcaneum (atteinte de la sous-talienne et la tibiotarsienene dans deux cas et atteinte de la sous-talienne dans quatre cas).

The purpose of this study is to evaluate the early results of the Ponseti method and the effectiveness of the Steenbek foot abduction brace. A total of 74 patients with 110 idiopathic clubfeet were included in this prospective study. The feet were evaluated according to the Dimeglio-Bensahel classification, the Catteral-Pirani classification and the functional classification of the Hospital for Joint Diseases. Ninety-eight feet (89%) had a good result after the casting period. All the feet evaluated after the period of full-time bracing and during the period of part-time bracing showed a good correction. The Ponseti method using the Steenbek foot abduction brace is effective in correcting idiopathic clubfeet.

Resume Nous rapportons une serie de 28 cas d’osteomyelite du col du femur afin de mettre en evidence les particularites cliniques et paracliniques de cette localisation. Le tableau clinique non specifique etait fait d’un syndrome douloureux de la hanche dans un contexte febrile. Le diagnostic de l’osteomyelite du col du femur a ete realise en se basant, sur l’imagerie (IRM et scintigraphie) dans trois cas avec une preuve bacteriologique dans deux cas, sur les constatations operatoires qui ont confirme l’atteinte du col dans 19 cas et sur les modifications de l’aspect radiologique du col dans six cas. Le traitement a ete medical dans tous les cas, 25 malades ont du subir un acte chirurgical. On a note cinq complications thromboemboliques et cinq cas d’evolution vers une pandiaphysite femorale. Nos resultats ont ete analyses avec un recul moyen de trois ans et demi. Sur le plan fonctionnel, la mobilite de la hanche etait complete dans 78 % des cas. On a observe quatre cas de raideur de la hanche et deux cas d’ankylose. Sur le plan anatomique, on a note deux cas de necrose cephalique partielle et deux cas de necrose totale de la tete et du col. L’analyse de nos resultats a montre que le pronostic de l’osteomyelite du col du femur est fonction du delai de prise en charge. Les malades traites tardivement presentent des mauvais resultats. L’evolution vers une pandiaphysite est un facteur pejoratif.

Objective: In the present study, we investigate the biological performance of a calcium phosphate ceramics (CPC) bone substitute combined with poly-hydroxybutyrate-co-hydroxyvalerate (PHBV). Materials and Methods: A particulate CPC [45% beta-tricalcium phosphate ([Formula: see text]-TCP) and 55% of dihydrated dicalcium phosphate (DCPD)] was incorporated into a biodegradable copolymer PHBV. Two series of the composite, 1 and 2, with CPC–PHBV weight ratios of (40%–60% and 60%–40%), respectively, were prepared using chloroform for dissolving the polymer and a pressure molding process for shaping the composite samples. After particle size analysis, the two composites were characterized by scanning electron microscopy (SEM) and energy dispersive spectrometry (EDS). In a second step, a 10[Formula: see text]mm bony segmental defect created in the tibias of 20 New Zealand White Rabbits was filled randomly with either composite 1 for group 1 or composite 2 for group 2. There were 10 animals in each group. Clinical, radiological and histological assessments were then carried out to evaluate the biological properties of developed CPC–PHBV composites. Results: For both variants of the developed CPC–PHBV biocomposite, there was evidence of osseous consolidation within three months. An in vivo investigation revealed the biological properties of the biocomposite, namely, biocompatibility, bioactivity, biodegradability and osteoconductivity. The morphological characteristics, granule size and chemical composition, were indeed found to be favorable for osseous cell development. This study likewise showed lower mortality for the variant with weight ratio (40%CPC–60%PHBV). Conclusion: An in vivo investigation revealed that the new biomaterial composed of CPC and PHBV exhibits manifest osteoconductivity and bioactivity with better degradation kinetics than the CPC. Moreover, the variant with 40%CPC/60%PHBV appeared more resistant to infection than the 60%CPC/40%PHBV which is an indicator of biocompatibility.

This research paper deals with the development of a medical robotized control system for supracondylar humeral fracture treatment. Concurrent access to shared resources and applying reconfiguration scenarios can jeopardize the safety of the system.A new methodology is proposed in this paper, termed BROMETH, to guarantee the safety of such critical systems from their specification to their deployment, and passing through certification and implementation. The solution is applied to a real case study named Browser-based Reconfigurable Orthopedic Surgery (abbrev. BROS), a robotized platform dedicated to the treatment of supracondylar fractures, to illustrate the paper's contribution. This work starts from a medical issue, namely supracondylar humeral fracture treatment, to establish a new informatics solution, namely a new methodology to design safe reconfigurable medical robotic systems.The results of the experiments performed on real SCH fracture radiographies were quite satisfactory.Clinical experiments can then be performed after deploying the system on real hardware.

Resume But. – Le but de ce travail etait de rappeler qu’il existe de veritables paralysies du plexus brachial d’origine infectieuse osteoarticulaire. Observations. – Il s’agissait de trois nourrissons âges de moins de trois mois et d’un nouveau-ne de six jours qui ont presente une paralysie du plexus brachial dont la cause etait une osteoarthrite de l’epaule. Le diagnostic de l’osteoarthrite a ete fait sur des arguments cliniques, biologiques, d’imagerie et evolutifs. Dans un cas, le germe causal, un Enterobacter, a pu etre isole. Le diagnostic de la paralysie etait essentiellement clinique. Dans un cas, une electromyographie a mis en evidence la souffrance du plexus brachial. Le traitement a associe une antibiotherapie et des ponctions iteratives. La recuperation etait complete dans les quatre cas dans un delai de moins d’un mois. Commentaires. – L’infection osteoarticulaire de l’epaule est reconnue actuellement comme une cause de paralysie du plexus brachial. Une thrombophlebite septique du vaisseau nourricier des nerfs ou une compression extrinseque sont incriminees dans la genese de la paralysie. Le diagnostic et le traitement de l’infection doivent etre precoces.

Dirofilariasis is a zoonosis affecting dogs and cats. It was transmitted to man by mosquito bites. Human dirofilariasis is rare. We report a case of 4-year-old girl presented with a subcutaneous palmar nodule of the hand. Surgical excision shows a nodule encircling the forth flexor tendon. The histological examination established the diagnosis by the presence of an adult worm identified as Dirofilaria repens. Surgical excision was curative.

Background This research paper deals with the development of a medical robotized control system for supracondylar humeral fracture treatment. Concurrent access to shared resources and applying reconfiguration scenarios can jeopardize the safety of the system. Methods A new methodology is proposed in this paper, termed BROMETH, to guarantee the safety of such critical systems from their specification to their deployment, and passing through certification and implementation. The solution is applied to a real case study named Browser-based Reconfigurable Orthopedic Surgery (abbrev. BROS), a robotized platform dedicated to the treatment of supracondylar fractures, to illustrate the paper's contribution. This work starts from a medical issue, namely supracondylar humeral fracture treatment, to establish a new informatics solution, namely a new methodology to design safe reconfigurable medical robotic systems. Results The results of the experiments performed on real SCH fracture radiographies were quite satisfactory. Conclusions Clinical experiments can then be performed after deploying the system on real hardware.

The purpose of this study was to assess the impact of Multi Slice Computed Tomography (MSCT) on the understanding of the spatial displacement of supracondylar humeral (SCH) fractures, their classification and their management. A prospective study was conducted on 63 children with SCH fractures Gartland II or Lagrange 2 and 3, over a period of 30 months. The patients were 42 boys and 21 girls, aged between 3 and 14. All patients were imaged using conventional radiography. Thirty-two patients underwent MSCT and 3-dimensional reconstructions. According to the Lagrange classification system, 16 patients had type 2 fractures and 47 had type 3 fractures. In type 2, the posterior cortices of both medial and lateral columns were bent on CT (n = 6). In type 3, CT-scan made it possible to distinguish two subgroups. In the first subgroup (n = 12) there was fracture of both anterior and posterior cortices of the lateral column; however, the posterior cortical surface of the medial column was preserved. In the second subgroup (n = 14), there was no cortical surface contact in the medial column, but the continuity of the posterior cortical surface of the lateral column was preserved. Based on a new concept of column stability, the use of CT-scan has allowed for a better understanding of supracondylar fractures in children.

To determine the demographic, clinical, biological and bacteriological profile of acute community acquired hematogenous osteomyelitis (AHO) in children.Prospective study including children admitted for AHO. We noted the demographic parameters of patients and the clinical, biological and radiological characteristics of the infection. Blood cultures and local specimen in operated children were systematically performed.70 patients were included. The mean age was 7.7 years. The mean time between onset of symptoms and admission was 3.2 days. Distal tibia was the most frequent localization (18.66%). Fever higher than 38° on admission was found in 92.8% of patients. Creactive protein (CRP) was superior to 20 mg / L in 95.8% and ESR superior to 20 mm in the first hour in 92% of cases. A deep venous thrombosis was found in 7 patients and a pleuropulmonary Staphylococcus infection in 4 patients. A micro organism was isolated in 64.7% of cases. Staphylococcus aureus methicillin susceptible (SAMS) was the predominant germ. Staphylococcus aureus methicillin resistant (SAMR) accounted for 15.7% of staphylococcus aureus infections. The importance of CRP on admission and time to resolution of fever after the start of treatment were significantly higher in SAMR infections. The existence of deep venous thrombosis and a pleuropulmonary Staphylococcus infection and the need for surgical drainage were significantly more frequent in SAMR infections.The existence of a severe form of AHO should lead to a high suspicion of SAMR infection and prompt the prescription of an appropriate antibiotiotherapy.

Soft tissue chondroma is a rare benign tumour, which is generally seen in adult. It consists of islands of heterotopic cartilaginous tissue and most localised on the hands and the feet. The hypothesis that microtrauma is involved in the aetiology of this condition has yet to find any factual support.To report two paediatric cases of soft tissue chondroma.The first is a soft tissue chondroma of the posterior aspect of the left axilla in a 3-year-old boy. CT scans showed a spherical fatty density soft tissue mass without evident calcifications, attaching the infraspinous muscle. The second patient is a 9-year-old girl presented with a right auricular finger soft tissue chondroma. Radiographs showed several punctuated calcifications with adjacent bone scalloping. MRI revealed a lobulated soft tissue mass attaching the flexor tendons. The tumours were entirely removed. Histological examination showed cartilaginous tissue in both cases. At follow-up, the patients had good functions without evidence of recurrence.Simple excision should suffice to treat soft tissue chondroma but care should be taken to make the excision complete if recurrence are to be avoided.

Lipomatous tumours of the limbs in children are rare, and lipoblastoma is the most common soft tissue tumour. Most of them have typical imaging features, but their clinical presentation and their management may vary, depending on the exact histological subtype. The aim of our study is to illustrate the main clinical, radiological and histological features of the different benign lipomatous tumours in children.Review of the literature.It is about a descriptive study of paediatric cases of benign lipomatous tumours of limb in children.The imaging findings are helpful and can provide essential components for the diagnosis.

Idiopathic tumoral calcinosis is an unusual benign condition characterized by the presence of calcified soft tissue masses of varying size around the joints. In this retrospective study,clinical data and radiological features of nine cases of idiopathic tumoral calcinosis are reviewed. Imaging features, particularly magnetic resonance imaging findings are detailed.

Shoulder sequelae of obstétrical brachial plexus palsy put a different problem of coverage according to the age of the patients and the presence or not of ostéo-articular deformations. At an advanced age and in the presence of ostéo-articular deformations, the muscles liberation and transfers tendineux only are insufficient for the restoring of a satisfactory function to the paralytic shoulder.The purpose of this study is to report an original technique by the association of libertation of retracted muscles and a humeral osteotomy to improve the abduction and to acquire an active external rotation in internal rotation retraction of the shoulder sequelae of obstétrical brachial plexus palsy.This retrospective study concerned twelve patients admitted in the service of Childish Orthopaedics of Children's hospital of Tunis between 1997 and 2003. The average age of the patients are 11 years. All the patients have a proximal humeral osteotomy above the deltoïdien V with a desinsertion of the Subscapularis and to the transfer of the Latissimus Dorsi and Teres Major, realized by a single posterior approch.After a mean follow up of 48 month a frank aesthetic and functional improvement was noted in every case.The importance of retraction for an advanced age, made that an humeral osteotomy of external derotation is necessary. Have a practice above the deltoïdien V it allows to improve at the same time the external rotation and the abduction due to the lateral translation of the deltoid. This last one is strengthen by the désinsertion of a retracted Subscapularis and levying of the co-contractions of the Latissimus Dorsi and Teres major with the deltoid almost constant.

Septic arthritis of a lumbar facet joint (SALFJ) is a very rare condition. It has mostly been described in adults. Only one other paediatric case has been reported. We present a case of septic arthritis of the left L5-S1 lumbar facet joint, associated with epiduritis and paraspinal abscess, in an 8-year-old boy. Plain radiographs and Technetium bone scan were negative. The diagnosis was made by blood cultures, which isolated staphylococcus epidermidis, and by MRI. The child was treated successfully with antibiotics only.

The authors report two cases of bone disorders in children with short stature, with confirmed growth hormone (GH) deficiency treated by GH supplementation. The first patient, aged 15 years, developed avascular necrosis of the femoral head and scoliosis. The second one, aged 17 years, had avascular necrosis of the femoral capital epiphysis on one side and acute slipped capital femoral epiphysis (SCFE) on the other side. All these complications were diagnosed while they were receiving GH-therapy. The exact aetiology and the role of GH in the pathogenesis of these conditions are still unknown.

Introduction L’osteomyelite aigue de l’ischion est une entite rare. Le tableau clinique est souvent atypique rendant le diagnostic difficile. Nous rapportons une serie de sept cas d’osteomyelites de l’ischion afin d’etudier les particularites cliniques et para-cliniques de cette localisation osteomyelitique. Materiel et Methodes Il s’agissait de sept garcons ayant un âge moyen de neuf ans et demi avec des extremes de cinq ans a 12 ans. Dans un cas, l’atteinte etait bilaterale. On a note un retard de prise en charge avec un delai moyen symptomes-consultation de cinq jours et un delai moyen consultation-hospitalisation de huit jours. Le tableau clinique n’etait pas specifique. Le syndrome febrile n’etait pas present dans tous les cas. On a note une fievre a 38,6C en moyenne et la temperature n’etait superieure a 38,5C que dans quatre cas. La symptomatologie clinique se resumait a un syndrome douloureux de la hanche dans cinq cas. La douleur etait abdomino-pelvienne dans deux cas. L’examen physique initial n’a note la douleur exquise ischiatique que dans deux cas. — Le diagnostic de l’osteomyelite de l’ischion a ete retenu comme suit ; — dans 4 cas : en se basant sur le resultat d’IRM et en isolant le germe pathogene ; — dans 1 cas : en se basant sur la radiographie standard initiale qui a montre une geode au niveau de l’ischion, l’IRM qui a montre des signes en faveur de l’osteomyelite de l’ischion et la chirurgie qui a permis d’evacuer une collection purulente ; — dans 2 cas : en se basant sur le resultat de la scintigraphie qui a montre une hyperfixation au niveau de la branche ischio-pubienne. Le traitement etait medical dans un cas et medico-chirurgical dans six cas. Resultats Nos resultats ont ete juges avec un recul moyen de trois ans avec des extremes de un a dix ans : Tous les malades ont recupere une fonction normale. Aucune complication n’a ete observee. Discussion Les osteomyelites hematogenes pelviennes sont rares (2 a 11 % des osteomyelites). La localisation au niveau de l’ischion est exceptionnelle. Les auteurs discutent les particularites, cliniques, para-cliniques et therapeutiques de cette localisation osteomyelitique. Conclusion Devant une boiterie douloureuse et febrile chez un enfant, la palpation des reperes osseux au niveau du bassin au cours de l’examen physique, est capitale afin de detecter une eventuelle osteomyelite pelvienne. L’IRM est d’un grand d’apport pour le diagnostic precoce de l’osteomyelite de l’ischion.

The authors report 2 cases of 2 children aging 11 and 12-years-old presenting hydatitosis in the upper extremity of 2 long bones femur and tibia. In 2 cases, radiological appearances were atypical. In the femur, plain radiographs revealed multiple lucencies, irregular, located in the superior extremity with a periostal reaction. The CT scan confirmed these data and showed a cortical rupture, extension to soft tissue with contrast enhancement. In the tibia, plain radiographys showed delimitated lucencies, confluent with a rim condensation in the proximal epiphyseal-metaphyseal area. Echography and CT are helpful when radiological appearances are unusual.