Tag Archive for: Case report

Small Shoulders, Big Burden: Scapular Osteomyelitis in an Infant

Case Report | Volume 12 | Issue 1 | January-April 2026 | Page: 16-18 | Dyan D’ Souza, Karthik Shyam, Binu T Kurian, Shubha A M

DOI- https://doi.org/10.13107/ijpo.2026.v12.i01.260

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2026; The Author(s).

Submitted: 31/10/2025; Reviewed: 24/11/2025; Accepted: 11/01/2026; Published: 10/02/2026

Authors: Dyan D’ Souza MS, MCh (Paed Surgery) [1], Karthik Shyam MD Rad [2], Binu T Kurian MS Ortho [3], Shubha A M MS, MCh (Paed Surgery) [1]

[1] Department of Paediatric Surgery, St Johns National Academy of Health Sciences Bangalore, Karnataka, India
[2] Department of Radiodiagnosis, St Johns National Academy of Health Sciences Bangalore, Karnataka, India
[3] Department of Orthopaedics, St Johns National Academy of Health Sciences Bangalore, Karnataka, India

Address of Correspondence

Dr. Shubha A M,
Department of Pediatric Surggery, St Johns National Academy of Health Sciences Bangalore, Karnataka, India
E-mail: dramshubha@yahoo.co.in

Abstract

Background: A mass in relation to the scapula is rare in infancy, causing a diagnostic dilemma. We report a case in an infant presenting with scapular osteomyelitis and highlight the management of this condition.
Case report: A 2-month-old male child presented with an atraumatic swelling in the right scapular region with decreased movements of the upper arm for 15 days with no response to antibiotics. A diffuse firm to hard swelling in the right scapular region, with increased temperature and tenderness restricting both passive and active movements at the shoulder joint was noted on examination. Though total counts and C- reactive protein were raised, the blood culture was sterile. Plain X-ray and MRI revealed osteomyelitis of the right scapula. Biopsy further confirmed the diagnosis. Good response was noted to treatment with antibiotics and physiotherapy
Conclusion: A scapular mass without shoulder arthritis, longer duration of symptoms, negative cultures and the absence of sepsis are notable features in this case. Emphasis is on prompt diagnosis and treatment with antibiotics and appropriate physiotherapy to prevent long term complications.
Keywords: Infant, Scapula, Osteomyelitis, Antibiotics, Case report

References

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10. Obeidat MM, Omari A. Osteomyelitis of the scapula with secondary septic arthritis of the shoulder joint. Singapore Med J. 2010;51:1–2.
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12. Caffey J. Infantile cortical hyperostosis; a review of the clinical and radiographic features. Proceedings of the Royal Society of Medicine. 1957;50(5):347–354. doi: 10.1177/003591575705000516.
13. Unkila-Kallio L, Kallio MJ, Peltola H, Eskola J. Serum C-reactive protein, erythrocyte sedimentation rate, and white blood cell count in acute hematogenous osteomyelitis of children. Pediatrics. 1994;93(1):59–62.
14. Pratik Phansopkar, Priya tikhile, Radhika Sawal, et al. Early physiotherapy rehabilitation approach enhances recovery in rare acute tibial osteomyelitis post-operative in a 9year old child. Medical Science, 2020, 24(104), 2482-2486.

How to Cite this Article:  D’ Souza D, Shyam K, Kurian BT, Shubha AM. Small Shoulders, Big Burden: Scapular Osteomyelitis in an Infant. International Journal of Paediatric Orthopaedics. January-April 2026; 12(1): 16-18.

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Pyomyositis of Iliacus in an Adolescent: A Case Report

Case Report | Volume 12 | Issue 1 | January-April 2026 | Page: 8-11 | Kushagra Vashisht, Sudhir Rana, Parmanand Gupta

DOI- https://doi.org/10.13107/ijpo.2026.v12.i01.256

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2026; The Author(s).

Submitted: 17/10/2025; Reviewed: 06/11/2025; Accepted: 08/01/2026; Published: 10/02/2026

Authors: Kushagra Vashisht MS Ortho [1], Sudhir Rana MS Ortho [1], Parmanand Gupta MS Ortho [1]

[1] Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India

Address of Correspondence

Dr. Parmanand Gupta,
Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India
E-mail: drpgupta123@gmail.com

Abstract

Pyomyositis of the iliacus muscle is rare in children and adolescents. It has an overlapping presentation with septic arthritis of the hip or spondylodiscitis. A 15-year-old boy presented with progressive left hip pain, fever, and limp. T2 weighted MRI images revealed hyperintensities in the iliacus and piriformis muscles. Open surgical drainage was performed with postoperative antibiotics. Hip arthrotomy was not carried out. Complete healing with resolution of symptoms occurred at 2 weeks. This case highlights the importance of prompt imaging and surgical intervention in managing rare musculoskeletal infections, as well as the need for clinicians to maintain a high suspicion for pyomyositis adjacent to the hip joint and avoid unnecessary arthrotomy.
Keywords: Pyomyositis, Iliacus, Hip, Case report

References

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3. Zvulunov A, Gal N, Segev Z. Acute hematogenous osteomyelitis of the pelvis in childhood: Diagnostic clues and pitfalls. Pediatr Emerg Care. 2003 Feb;19(1):29-31
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5. Mignemi ME, Menge TJ, Cole HA, Mencio GA, Martus JE, Lovejoy S, Stutz CM, Schoenecker JG. Epidemiology, diagnosis, and treatment of pericapsular pyomyositis of the hip in children. J Pediatr Orthop. 2014 Apr-May;34(3):316-25.
6. Central TB Division, Ministry of Health & Family Welfare, Government of India. (2017). Index-TB Guidelines: Guidelines on extrapulmonary tuberculosis for India. Indian Journal of Medical Research, 145(4), 448–463. Indian Journal of Medical Research.
7. Jain VK, Iyengar KP, Botchu R, Vaishya R. Sacroiliac joint tuberculosis revisited – A clinico-radiological review. J Clin Orthop Trauma. 2021 Nov 16;24:101707
8. An etiologic shift in infantile osteomyelitis: The emergence of the group B streptococcusEdwards, Morven S. et al. The Journal of Pediatrics, Volume 93, Issue 4, 578 – 583\
9. Nicole I. Montgomery, Howard R. Epps, Pediatric Septic Arthritis, Orthopedic Clinics of North America,Volume 48, Issue 2,2017,Pages 209-216
10. Eugen Cohen, Tiberiu Katz, Eldad Rahamim, Shlomi Bulkowstein, Yaron Weisel, Ron Leibovitz, Yariv Fruchtman, Eugene Leibovitz, Septic arthritis in children: Updated epidemiologic, microbiologic, clinical and therapeutic correlations, Pediatrics& Neonatology, Volume 61, Issue 3,2020,Pages 325-330
11. Kim EY, Kwack KS, Cho JH, et al. Usefulness of dynamic contrast enhanced MRI in differentiating between septic arthritis and transient synovitis in the hip joint. AJR Am J Roentgenol. 2012; 198:428–433.
12. Kirkhus E, Flato B, Riise O, et al. Differences in MRI findings between subgroups of recent-onset childhood arthritis. PediatrRadiol. 2011;41:432–440.
13. Mazur JM, Ross G, Cummings J, et al. Usefulness of magnetic resonance imaging for the diagnosis of acute musculoskeletal infections in children. J Pediatr Orthop. 1995;15:144–147.
14. Key role of magnetic resonance imaging in the diagnosis of infections around the hip and pelvic girdle mimicking septic arthritis of the hip in children. J Pediatr Orthop B. 2016 May;25(3):234-40.
15. Montgomery CO, Siegel E, Blasier RD, et al. Concurrent septic arthritis and osteomyelitis in children. J Pediatr Orthop. 2013;33: 464–467.

How to Cite this Article:  Vashisht K, Rana S, Gupta P. Pyomyositis of Iliacus in an Adolescent: A Case Report. International Journal of Paediatric Orthopaedics. January-April 2026; 12(1): 08-11.

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Focal Fibrocartilaginous Dysplasia of the Distal Femur with Secondary Genu Valgum and Patellar Dislocation: Case Report and Literature Review

Case Report | Volume 11 | Issue 2 | May-August 2025 | Page: 21-26 | Rakesh Kumar, K. Venkatadass, S. Rajasekaran

DOI- https://doi.org/10.13107/ijpo.2025.v11.i02.234

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2025; The Author(s).

Submitted: 09/10/2024; Reviewed: 02/11/2024; Accepted: 11/06/2025; Published: 10/08/2025

Authors: Rakesh Kumar DNB Ortho [1], K. Venkatadass MS Ortho [1], S. Rajasekaran MS Ortho [1]
[1] Department of Orthopaedics and Spine Surgery, Ganga Hospital, Coimbatore, Tamil Nadu, India.

Address of Correspondence
Dr. K Venkatadass
Fellow in Paediatric Orthopaedics, Department of Orthopaedics and Spine Surgery, Ganga Hospital, Coimbatore, Tamil Nadu, India.
E-mail: Vk@gangahospital.net

Abstract

Background: Focal fibrocartilaginous dysplasia (FFCD) is a rare fibrous dysplasia that predominantly affects the long bones of children, often leading to angular deformities and limb length discrepancies. The condition is characterized by the presence of fibrous tissue and hyaline cartilage and can mimic other bone disorders.
Case Presentation: A 3-year-old girl presented with progressive left-sided genu valgum and patellar dislocation, noticed since the onset of ambulation at 18 months. Initial management involved observation, but due to worsening symptoms, further evaluation was sought. Clinical examination revealed a range of motion of the left knee from 0 to 100 degrees and lateral dislocation of the patella at 60 degrees of flexion. Radiological assessments showed a mechanical lateral distal femur angle (mLDFA) of 59 degrees and a well-defined fibrotic band on MRI, indicative of FFCD. A limb length discrepancy of 2 cm was present.
Intervention: Surgical management involved curettage of the fibrocartilaginous lesion and a corrective osteotomy using the LRS (Limb Reconstruction System) assisted technique, combined with the Roux-Goldwaith procedure to address the patellar dislocation.
Outcome: Postoperative follow-up over seven months showed satisfactory alignment of the femur, normal patellar tracking, and correction of the limb length discrepancy. Histological analysis confirmed the diagnosis of FFCD.
Conclusion: The combined approach of curettage and corrective osteotomy, along with soft tissue procedures, effectively managed the angular deformity and patellar dislocation in this case of FFCD. This case underscores the importance of early surgical intervention in managing progressive deformities associated with patellar dislocation due to FFCD.
Keywords: Focal fibrocartilaginous dysplasia, FFCD, Genu valgum, Femur deformity, Roux Goldwaith procedure, Curettage, Case report.

References

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2. Muezzinoglu B., & Oztop F. (2001). Fibrocartilaginous dysplasia: a variant of fibrous dysplasia. The Malaysian Journal of Pathology, 23(1), 35-39.
3. Choi I. H., Kim C. J., Cho T. J., Chung C. Y., Song K. S., Hwang J. K., et al. (2000). Focal fibrocartilaginous dysplasia of long bones: report of eight additional cases and literature review. Journal of Pediatric Orthopedics, 20(4), 421-427.
4. Bian Z., Lyu X., Guo Y., Zhu Z., Feng C., Yang J., et al. (2020). Focal fibrocartilaginous dysplasia of the distal femur. Journal of Pediatric Orthopaedics B, 29(5), 466-471. https://doi.org/10.1097/BPB.0000000000000742
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7. Johari A., & Anjum R. (2019). Spontaneous resolution of focal fibrocartilaginous dysplasia of femur on long-term follow-up: case report and review of literature. Journal of Pediatric Orthopaedics B, 28(2), 127-131. https://doi.org/10.1097/BPB.0000000000000570
8. Ruchelsman D. E., Madan S. S., & Feldman D. S. (2004). Genu Valgum Secondary to Focal Fibrocartilaginous Dysplasia of the Distal Femur. J Pediatr Orthop, 24(4).
9. Langenskiöld A. (1989). Tibia vara. A critical review. Clinical Orthopaedics and Related Research, (246), 195-207.
10. Bell S. N., Campbell P. E., Cole W. G., & Menelaus M. B. (1985). Tibia vara caused by focal fibrocartilaginous dysplasia. Three case reports. The Journal of Bone and Joint Surgery. British Volume, 67(5), 780-784. https://doi.org/10.1302/0301-620X.67B5.4055881
11. Beaty J. H., & Barrett I. R. (1989). Unilateral angular deformity of the distal end of the femur secondary to a focal fibrous tether. A report of four cases. The Journal of Bone and Joint Surgery. American Volume, 71(3), 440-445.
12. Zayer M. (1992). Tibia vara in focal fibrocartilaginous dysplasia. A report of 2 cases. Acta Orthopaedica Scandinavica, 63(3), 353-355. https://doi.org/10.3109/17453679209154802
13. Albiñana J., Cuervo M., Certucha J. A., Gonzalez-Mediero I., & Abril J. C. (1997). Five additional cases of local fibrocartilaginous dysplasia. Journal of Pediatric Orthopedics. Part B, 6(1), 52-55. https://doi.org/10.1097/01202412-199701000-00011
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15. Welborn M. C., & Stevens P. (2017). Correction of Angular Deformities Due to Focal Fibrocartilaginous Dysplasia Using Guided Growth: A Preliminary Report. Journal of Pediatric Orthopaedics, 37(3), e183-e187. https://doi.org/10.1097/BPO.0000000000000785

How to Cite this Article:  Kumar R, Venkatadass K, Rajasekaran S. Focal Fibrocartilaginous Dysplasia of the Distal Femur with Secondary Genu Valgum and Patellar Dislocation: Case Report and Literature Review. International Journal of Paediatric Orthopaedics . May-August 2025; 11(2):21-26 .

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