Melioidosis is an uncommon infection caused by a Gram-negative bacillus, Pseudomonas pseudomallei. Only a few case reports of orthopaedic infection have been published in English, and most were of isolated septic arthritis or secondary to melioidosis of another organ. We have reviewed ten patients with localised melioidotic osteomyelitis; six had underlying conditions. We discuss the importance of obtaining a bacteriological diagnosis, and of surgical debridement as well as appropriate antibiotic therapy.

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INTRODUCTIONChondroblastoma (CB) is a rare, benign, cartilaginous lesion of the bones that accounts for less than 1% of primary bone tumours.(1,2) It typically develops from the epiphysis of skeletally immature patients. (3,4) Peak incidence of CB is seen in the second decade of life, (5,6) and has been reported to occur more frequently in men than in women. (5,(7)(8)(9)(10) Although CB has a predilection for tubular bones such as the humerus, femur, tibia and metatarsus, (7,11) it can also be found in non-tubular bones (NTBs) such as flat bones (i.e. skull, maxilla and pelvis) (7) and epiphysoid bones (i.e. trapezium, (12) cuboid, (13,14) talus (15,16) and patella (17) ).Multifocal benign CB has also been reported. METHODSThis study was approved by the ethics committee at the Ramathibodi Hospital, Bangkok, Thailand (ID-10-52-01). We retrospectively reviewed the medical records of all patients with pathologically proven CB at our hospital during a 37-year period . A total of 31 patients (16 men; 15 women)

Paget's bone disease is quite common in some parts of Europe and countries inhabited by European emigrants, but it is rare in Asia. There have been only 13 reported cases in Southeast Asia, including one reported case from Thailand. Half of the previously reported cases had bone symptoms and the other half were asymptomatic, but were incidentally discovered when patients were being investigated for other medical problems. Here are reported cases of four asymptomatic patients who presented elevation of serum alkaline phosphatase during routine annual medical checkups. All patients were of Chinese descent and all cases were proven by biopsy. Based on this experience, we are of the opinion that a substantial number of unrecognized cases of Paget's disease exist among ethnic Thais. We feel that they would be revealed if clinicians were alerted of its presence and if they included it as a possible diagnosis together with metastasis and osteoporosis when examining bone lesions or when results for elevated serum alkaline phosphatase are detected during routine checkups. We also anticipate that a higher prevalence of this disease may occur in future Thai generations due to the addition of offspring from Asian-European intermarriages to offspring of Chinese descent in the ethnic Thai population.