Multicentric/massive idiopathic osteolysis in a 17-year-old girl

An unusual case of multicentric/multifocal osteolysis with unique clinical and radiographic features in a 17-year-old girl is reported. The brother of the patient who was probably also affected could not be examined.

Caudal regression syndrome and spondyloepiphyseal dysplasia in a 6-year-old child. A new syndrome?

A 6-year-old Algerian boy with "caudal regression syndrome" and spondylo-epiphyseal dysplasia is reported. We believe this represents a new malformation syndrome or a random association of two non-related entities.

Rare, primary iliac, pubic and ischial tumours in children (report of 14 cases)--Part II

14 cases of rare, primary iliac, pubic and ischial bone tumours or tumorous conditions are reported. These include aneurysmal bone cyst, eosinophilic granuloma, cavernous haemangioma, osteoid osteoma, fibrous dysplasia, fibrous dysplasia with sarcomatous degeneration, chondrosarcoma, lymphoma and atypical malignant histiocytosis. The possibilities to be considered in the accurate radiographic recognition of primary tumours of iliac, pelvic and ischial bones are discussed.

Primary bone tumours of the pelvis in childhood--Ewing's sarcoma of the ilium, pubis and ischium (report of 30 cases). (Part I)

30 children with Ewing's sarcoma, the most common malignant pelvic tumour in childhood, were analysed. The diagnosis of Ewing's sarcoma is relatively easy and can be established in most of the cases on plain radiography. The diagnostic radiographic features of the tumour are discussed. The two most important conditions in differential diagnosis are eosinophilic granuloma and the rare primary bone lymphoma. Osteomyelitis should rarely cause confusion unless the clinico-radiographic findings are not properly evaluated.

Soft-tissue tumors of the hand and wrist of children

We report 23 children with soft-tissue tumors of the hand and wrist. Tumors of blood and lymph vessel origin accounted for nine patients; giant-cell tumors of tendon sheaths and tumoral calcinosis occurred in four patients each and soft-tissue chondroma in three. Synovial osteochondromatosis and aggressive fibromatosis were each represented by one patient. Finally, there was one child with a malignant soft-tissue tumor, an embryonal rhabdomyosarcoma of the hand. Hand and wrist ganglia were excluded. Imaging methods used in investigating hand and wrist lesions are discussed but plain radiography remains the first and often only examination necessary.

Primary rib tumours in children (report of 27 cases with short literature review)

27 cases of primary malignant and benign rib tumours are reported. The most common malignant rib tumour in childhood is Ewing sarcoma (20 cases). Some other rare bone tumours and tumorous conditions (reticulosarcoma, aneurysmal bone cyst, monostotic rib eosinophilic granuloma, osteoid osteoma and lymphangioma) are also described. In the authors' opinion Ewing sarcoma presents with characteristic clinico-radiographic findings in most of the cases. Other monostotic, primary rib tumours and tumorous conditions in childhood--with the exception of exchondroma and enchondroma--rarely show diagnostic radiographic features.

Congenital cystic adenomatoid malformation of the lung. Presentation of 16 cases

Congenital cystic adenomatoid malformation (CCAM) of the lung is one of the rarest causes of neonatal distress. The principal radiological sign of CCAM is an intrapulmonary mass of soft tissue density, containing cystic areas of different sizes and shapes. The mass usually compresses the rest of the affected lung and displaces the mediastinum and heart to the opposite side, compressing the lung which is often therefore hypoplastic. If CCAM is diagnosed in utero by ultrasound, the treatment of choice is surgery as soon as possible after birth, with good survival rates. Sixteen cases of CCAM are presented, one with bilateral disease, diagnosed at different times, and one with an associated prune belly syndrome, to be added to the 405 already reported in the literature, and their clinical, radiological and pathological features are described.

Traumatised ischial apophysis (report of six cases)

Six boys with traumatic ischial apophysis are reported. Two cases were diagnosed as stress apophysis and four as apophyseolysis. Two of our patients were referred to the hospital as malignant bone tumours--Ewing sarcoma and osteosarcoma.

Unusual radiographic manifestations of chondrodysplasia punctata

We present six cases of chondrodysplasia punctata with radiographic findings that are either very rare or previously unreported in this entity.

Familial X-linked unilateral carpal hypoplasia/dysplasia--a new syndrome. Report of four cases

Four boys with congenital hypoplastic/dysplastic carpal changes are reported. In 3 patients the right carpus and in 1 patient the left carpus was involved. Two other males, not examined, in two previous generations were also probably affected. No females in the family are known to have the disease. Unilateral involvement, absence of progress of the changes with age and type of inheritance allows us to designate the abnormality as a new, X-linked syndrome.

Mucolipidosis II: correlation between radiological features and histopathology of the bones

Twelve cases of Mucolipidosis II (I-cell disease) with a wide range of severity of skeletal involvement were studied. Pathological findings in two cases provided helpful information in understanding the radiographic features of dysostosis multiplex. Inhibition of the growth plate cartilage calcification and rickets-like lesions were observed in the metaphyses. Enhanced subperiosteal remodelling and paratrabecular fibrosis were also evident in the diaphyses. High levels of parathormone were found in one case. This finding supports the hypothesis that bone lesions may be secondary, at least in part, to damage in such viscera as the kidney and/or the liver and that they are mediated by vitamin D and parathormone.

Peripheral dysplasia. Report of a new genetic syndrome

A new, dominantly inherited form of peripheral dysplasia in three members of an Algerian family is reported. Two further individuals, not investigated, are also probably affected. The disease is characterised by distinctive clinico-radiological findings. A case of acromesomelic dysplasia of Maroteaux is also reported and the differential diagnosis of peripheral dysplasias is discussed.

The rib gap anomaly in partial or mosaic trisomy 8

Gaps in the first ribs were observed in two children, one with partial and the other with mosaic trisomy for chromosome 8. The sign may be considered in conjunction with other features as a relative indication for chromosomal studies.