IntroductionLimb subcutaneous emphysema secondary to a Munchausen syndrome represents a rare and severe entity because it involves the functional prognosis of the limb and vital prognosis of the patient.Case presentationWe report the case of an 18-year-old Moroccan woman patient who presented to our hospital with a subcutaneous emphysema of the shoulder girdle and the right arm, caused by our patient. Treatment was aggressive, with a wide surgical debridement, parenteral antibiotic therapy and hyperbaric oxygen therapy. The results have been favorable.ConclusionsThe correlation of anamnestic data and clinical and para-clinical exams were essential for the diagnosis of Munchausen syndrome in this case. In this regard, we report a rare case of subcutaneous limb emphysema secondary to Munchausen syndrome.

BackgroundAn acetabular location of osteoid osteoma is rare and represents less than 1 % of cases. The purpose of this clinical case report is to highlight the unusual location of osteoid osteoma and the technical difficulty of its removal.Case presentationWe report a case of a 17-year-old Moroccan Arab boy who presented with pain in his right hip with lameness. The diagnosis of osteoid osteoma was made by imagery and confirmed by histological examination. The treatment consisted of a complete percutaneous resection scanno-guided of the nidus. The evolution was marked by complete healing with total and definitive disappearance of symptoms after 1 year.ConclusionsOsteoid osteoma of the acetabular roof is rare. The diagnosis is now easy because of the evolution of imaging. Treatment is exclusively surgical. Complete resection guarantees the absence of recurrence. The difficulty of the surgical procedure is due to the deep localization of the osteoid osteoma and because it is endosseous, it is also dangerous due to anatomical relationships and the small size of the osteoid osteoma.

Abstract:Myxofibrosarcoma or myxoid variant of malignant fibrous histiocytoma (MFH) is one of the most common sarcomas in the extremities in adults and particularly in elderly patients. It is characterized by a high frequency of local recurrence. We report a patient with high grade myxofibrosarcoma infiltrating the striated muscle of the right forearm. On microscopic examination, the tumor lacked areas of necrosis and pronounced cellular pleomorphism. Immunohistochemically, the tumor cells showed intense reactivity to S-100 protein (PS 100) and discrete reactivity of desmin, CD34 and SMA. After surgery of the tumor, the patient received local radiotherapy and chemotherapy. One year after treatment, the patient has been alive without local recurrence or distant metastasis.

The use of prosthetic implants and metallic materials is widespread in modern orthopedic surgery. Generally, these materials are non-toxic and inert. Nevertheless, a few cases of malignancy associated with certain implants have been documented in the literature. It has been reported that some components of these implants have carcinogenic properties. In most cases, these tumors are high-grade sarcomas that occur in the bone or soft tissue adjacent to the implant site. Here we present the case of a 53-year-old patient who underwent intramedullary nailing of the tibia and developed a pleomorphic sarcoma at the implant site 18 years later.

Simultaneous bilateral anterior shoulder dislocation is rare, it often occurs after high energy trauma, we report a case of a 43-years-old male presented with bilateral anterior shoulder dislocation when he tries to stand up from the floor, shoulders in extension, abduction and external rotation. A closed reduction was performed without complications, and one month later the right shoulder was stabilized by open Laterjet technique. The evolution was favorable for both shoulders with no pain, recuperation of the range motion and no recurrence of dislocation. Through this case we underline the value of early diagnosis and appropriate treatment of bilateral anterior shoulder dislocation, to avoid complications and obtain good result.