The occurrence of extranodal primary B cell non-Hodgkin's lymphoma is rare. Total hip replacement is one of the most common orthopaedic procedures performed. There has been an increased incidence of primary lymphomas involving periprosthetic sites. Chronic inflammation due to metal debris arising from the prosthetic implants has been evidenced as one of the causes for the development of soft tissue lymphomas albeit rarely. We describe a case report of a 77-year-old patient who had underwent a cemented total hip replacement in the past who further developed large B cell primary non-Hodgkin's lymphoma. She presented initially with signs and symptoms highly suggestive of underlying periprosthetic infection. The radiological imaging was also indicative of periprosthetic infection. The diagnosis was eventually confirmed after an open biopsy. This case underlines the importance of considering and including soft tissue malignancy in the differential diagnosis of suspected chronic periprosthetic infection.
The pisiform is a sesamoid bone with in flexor carpi ulnaris tendon. Isolated dislocation of the pisiform bone is not common. It is usually missed and diagnosed as a soft tissue injury or a sprain of the wrist by the emergency physicians. We present an unusual and unique case of a young man involved in a rugby tackle and who himself presented to the emergency department with a painful wrist. The diagnosis of a dislocated pisiform was initially missed; however it was later successfully treated with an open reduction leading to a satisfactory outcome.Early diagnosis and reduction is imperative to avoid prolonged morbidity and loss of earnings. A high index of suspicion is needed in young patients with wrist trauma displaying ulnar sided wrist pain.
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