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.

A study of heel-pad thickness and compressibility using lateral radiographs, loaded and unloaded by body-weight, was carried out on 70 patients with plantar heel pain and 200 normal subjects. The heel-pad thickness and the compressibility index (resistance to compression) were greater in the patients than in normal subjects and significantly increased with age. In normal subjects, the thickness was greater in males than in females, but there was no significant difference in the compressibility. Increased weight led to an increase in heel-pad thickness and compressibility index. The body mass index was greater in patients with plantar heel pain than in normal subjects and 40% of the patients were considered to be overweight. Increase in the compressibility index indicates loss of elasticity and an increased tendency to develop plantar heel pain.