Palm needle induced pseudo-tumours of bone

Two children presented with recurrent swelling and pain, one in the forearm the other in the leg, without a history of a penetrating injury. It was difficult to arrive at a precise clinical diagnosis. X-ray films showed periosteal thickening in the diaphysis of the adjacent long bone with some unusual features but were suggestive of infection or tumour. Other extensive investigations did not contribute to a diagnosis. This was only achieved after surgical exploration. Both children had a 3 cm length of brittle palm needle within a soft tissue cavity adjacent to the long bone. The needles were from a commonly grown palm, Phoenix canariensis. Palm needle induced pseudo-tumour should always be considered in the differential diagnosis of bone neoplasm, particularly in childhood.