Ineffective erythropoiesis in patients with thalassemia intermedia drives extramedullary hematopoietic tumor formation in several parts of the body. Paraspinal involvement has received increasing attention due to the associated morbidity secondary to spinal cord compression. Although the history and physical examination may help narrow the differential diagnosis, radiographic imaging remains essential to confirm the existence of hematopoietic tissue. Characteristic appearance has been observed mainly on magnetic resonance imaging. Several treatment options have been described, including transfusion therapy, laminectomy, radiotherapy, and the use of fetal hemoglobin inducing agents that decrease the hematopoietic drive. However, the ideal management scheme remains controversial. Until large prospective trials evaluate the efficacy and safety of the available treatment options, both in single and in combination therapy, an individualized approach should be entertained.

No abstract

Chronic osteomyelitis is a relatively common infection and is often a lifelong disease. Traditionally, osteomyelitis has been treated with 4-6 weeks of parenteral antibiotics after definitive debridement surgery. Antibiotic-impregnated cement beads have also been used as adjuvant therapy for chronic osteomyelitis. However, this time frame of antibiotic treatment has no documented superiority over other time intervals, and there is no evidence that prolonged parenteral antibiotics will penetrate the necrotic bone. There is no solid evidence in the medical literature to support the continuous use of long duration antibiotic treatment for chronic osteomyelitis. A small number of comparative trials on the treatment of chronic osteomyelitis have been published. Also, the type of surgical procedures practiced in the past in treating chronic osteomyelitis and the lack of effective muscle flap application might have contributed to the prolonged antibiotic treatment. And although the surgical approach to the treatment of chronic osteomyelitis has advanced markedly, still the same duration of antibiotic treatment is adopted. In this review we question the continuous and traditional use of long-term antibiotic treatment for chronic osteomyelitis in spite of the advances in surgical treatment using flaps. The medical literature, including studies in animals and humans, was searched for evidence to support the use of short courses of antibiotics. We hope this review will provoke the initiation of animal studies and clinical trials assessing the use of short courses of antibiotics for chronic osteomyelitis.

We have studied retrospectively 37 hips in 36 children at an average of 91 months after simultaneous open reduction and Salter innominate osteotomy for developmental hip dysplasia. At the latest review 97.3% were clinically and 83.8% radiologically good or excellent. In three hips (8%) there were signs of avascular necrosis, but only one had been symptomatic. There were no cases of recurrent posterior displacement.