Introduction: Synovial chondromatosis of the knee is an unusual, rare, benign metaplastic neoplasm of the synovium, characterized by the formation of focal cartilaginous nodules in the synovium. It predominantly involves the anterior compartment of knee and extensive, disseminated involvement is rarely reported. Diagnosis is usually established with clinicoradiological imaging and confirmed by histology. The paucity of literature on the management of synovial chondromatosis puts an orthopedician in dilemma regarding the optimal surgical intervention. Case Report: We report a case of 50-year-old male who presented with severe pain and swelling in his left knee associated with functional incapacitation. Magnetic resonance imaging demonstrated diffuse proliferation of synovium with mild effusion displaying multiple, disseminated calcific nodules. We managed the case by open removal of loose bodies and radical synovectomy through combined anterior and posterior approach. At 4 years follow-up, there are no clinical or radiological signs of recurrence. Conclusion: Extensive involvement of the knee with calcific nodules is extremely rare. Treatment is controversial which usually includes removal of loose bodies combined with an open or arthroscopic synovectomy. Our case report recommends single stage, open retrieval of loose bodies combined with radical synovectomy to decrease the incidence of recurrence in extensive synovial chondromatosis. To the best of our knowledge, disseminated synovial chondromatosis of the knee, managed by open, combined approach, has been reported only once in the literature.

Introduction: Hibernoma is an uncommon benign tumor composed of multivacuolated brown adipocytes described in the literature a decade back. Intraosseous hibernomas are extremely rare with propensity to affect axial skeleton. Involvement of appendicular skeleton has been reported only twice in the literature till date. Case Report: We present a case of solitary, painless mass in the left proximal tibia mimicking neoplasm in a 35-year-old male. The plain radiographs revealed a lytic lesion with well-defined margin at the junction of metaphyseal-diaphyseal region of the left proximal tibia. The lesion was hyperintense on T2 and hypointense on T1 with heterogenous enhancement on contrast imaging. FDG-PET showed high uptake of fluorodeoxyglucose. Histopathological examination revealed the presence of multivacuolated cytoplasm with abundant mitochondria suggestive of hibernoma. On immunohistochemistry, the cells were positive for S-100. Conclusion: The findings of imaging modalities are non-specific and histopathological examination is required to confirm the diagnosis of hibernoma. Intraosseous hibernoma needs to be considered as a differential diagnosis of sclerotic bone lesion. Further, evaluation with regular follow-up with imaging will be required if the mass undergoes any clinical changes. Both radiologists and pathologists, need to be aware of this rare entity to avoid misdiagnosis of the uncommon lesion.

Introduction: Isolated Partial Heel pad injuries are very rare and management of heel pad injury is always a challenge to a surgeon because of its complex structure and precious blood supply. The goal of management is to preserve a viable heel pad for weight-bearing during normal gait. Case Report: A 46-year-old male sustained a right heel pad avulsion following motorcycle bike ac-cident. Examination showed contaminated wound, viable heel pad, and no bony injury. Within 6 h of trauma, we reattached partial heel pad avulsion using multiple Kirschner wires without wound closure and daily dressings. Full weight bearing started on 12th post-operative week. Conclusion: A partial heel pad avulsion can be managed using multiple Kirschner wire which is cost-effective and simple method. Partial-thickness avulsion injury has a better prognosis as com-pared to full-thickness heel pad avulsion injury, due to preserved periosteal blood supply.

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