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Keywords: osteolymphoma primary non-Hodgkin's lymphoma of the bone a b s t r a c t Osteolymphoma, also known as primary non-Hodgkin's lymphoma of the bone, is an unusual disease which can be difficult to diagnose. This case study concerns a 51-year-old patient who presented with right leg pain initially diagnosed as osteomyelitis. Failure of treatment and further investigation revealed an unusual primary tumour. We review the sequence of events leading to the diagnosis of osteolymphoma and the literature relating to the diagnosis.

Introduction: An observation was made that when removing self-tapping cortical screws from patients bones, stripping or shearing of the head of the screw occurred more often in screws whose cutting flutes sat in cortical bone compared with screws that had penetrated the distal cortex with flutes exposed. Method: A model was designed to simulate screws with their cutting flutes either in contact with cortical bone or deep to cortical bone. Screws were grouped depending on the location of their cutting flutes and removal torque was measured. Results: Eighteen screws were included in final analysis. There was a statistically significant difference in average initial removal torque and average maximal removal torque with screws with their cutting flutes in substrate requiring significantly more torque to remove. Conclusion: We conclude that self-tapping cortical screws whose cutting flutes sit in cortical substrate require more torque to remove and are therefore more likely to fail. This finding may be used as a guide in pre-operative planning for removal of metalwork from patients.

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