Introduction: Tuberculosis (TB), one of the oldest diseases known to affect humans, is caused by the bacteria Mycobacterium tuberculosis. The disease usually affects the lungs, although, in up to one-third of cases, other organs are involved. TB of the bone mimics other clinical conditions such as chronic osteomyelitis, Madura mycosis and actinomycosis. Case Report: A fifth child and last-born girl, in a family of living four children, aged 9 years, consulted Kigali University Teaching Hospital (CHUK) on December 7, 2017, from Kibuye Referral Hospital (Western of Rwanda) for ulcerated, infected left heel with swollen foot 4 months before our consultation. Physical examination revealed a patient with swollen and tender foot discharging serous bloody fluids accompanied by inability to stand with a painful right hip. Small left inguinal lymph nodes were present. Blood work-up, computed tomography scan of the left foot, and an incisional biopsy at the level of the left calcaneus were performed and revealed extrapulmonary TB. The histopathological features for TB were scanty, but the high index suspicion of possible extrapulmonary TB led to the confirmation of the diagnosis using auramine-rhodamine special stain. Anti-TB therapy for 12 months course was initiated and the monthly follow-up for 11 months was done. Conclusion: Although calcaneal TB is very rare, in countries with high incidence of TB, clinicians must have a high suspicion index and skeletal TB must be included in differential diagnosis of bone masses whenever possible bone mass biopsy and special staining technique in addition to most common diagnosis means should be done to rule out the possibility of bone TB. Keywords: Calcaneus, tuberculosis, Rwanda.

Background: A sacral parasitic twin is a variant of conjoined twins in which one twin is incomplete. Case: A female newborn was delivered by cesarean section. Reported inconclusive obstetrical ultrasonography at the first trimester where the pregnancy was initially diagnosed dizygotic and in the second and third trimester was monozygotic. The neonate was born with a mass in the sacrococcygeal region, which was excised 24 days after birth. The mass contained the scalp, skull, cervical spine bone, and brain, which were confirmed as parasitic twins. The post-operative and follow up periods were uneventful. Conclusion: Sacral parasitic rachipagus is a rare phenomenon; experienced antenatal ultrasonography may assist in the early diagnosis and excision is the treatment.

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