VARIANT OF HOFFA DISEASE: A CASE REPORT This report presents the case of an 18-year-old female student with a low BMI, who was otherwise healthy. She presented with chronic anterior right knee pain persisting for 1 year. The pain began spontaneously and gradually increased in severity, especially during long distance walking and standing for more than 15 minutes. The symptoms did not subside with medication and physiotherapy. All biochemical and radiological investigations to rule out other related possible aetiologies were unremarkable. The patient eventually underwent an arthroscopic knee surgery, during which the intraoperative findings revealed the Hoffa fat pad over the anteromedial knee joint. This was debrided and after surgery, she was symptom free and had resumed her normal activities.

Osteomyelitis accounts for the majority of bone infections with open fractures have higher rates of osteomyelitis in contrast to closed fractures. It is usually seen in open fractures with substantial contamination and soft tissue damage, as well as after internal fixation. Chronic osteomyelitis is recognised by continuance presence of microorganisms, sequestrum, low-level of inflammation and fistulae. The infection can be contained to the bone or spread to the soft tissues, periosteum, and bone marrow. The predominant aetiological agents are Staphylococcus aureus, Streptococcus species, Enterococcus species, Pseudomonas aeruginosa and Enterobacteriaceae, but rarely due to Bukholderia pseudomallei. We report a case of post-traumatic chronic osteomyelitis of tibia due to Bukholderia pseudomallei. This case emphasises the significance of considering melioidosis in patients with uncontrolled diabetes mellitus who have undergone surgical intervention and reside in a region where infectious diseases are prevalent.

Locked knee is an orthopaedic condition requiring urgent treatment. Although the condition can be diagnosed via history, physical examination and imaging studies, the cause of the mechanical obstruction may only be apparent during arthroscopic examination of the knee joint. It is known that imaging plays a role in evaluating the integrity of intra-articular structures, however in some atypical cases, imaging cannot identify the definitive cause of locked knee. Here we report on two cases of locked knee, due to uncommon conditions which were unobservable via normal imaging studies.