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• W13522005 abstract "Brodie’s abscess is a subacute form of hematogenous osteomyelitis, which results if an organism is less virulent or a child’s resistance is strong. Brodie’s abscess is difficult to diagnose because characteristic signs and symptoms of the acute form of the disease are minimal and non-specific. The initial infection is localized to a small area and is walled off by inflammatory fibrous tissue, usually in the metaphysic of tubular bones rarely traversing the physis into the epiphysis. These lesions are accompanied by minimal or absent periosteal reaction and may be so small that detection on plain radiograph is not possible.1 The preponderance of Brodie's abscesses in the lower extremities is probably due to trauma. This case report describes the uncommon condition involving distal left tibia. CASE REPORT A 13 years old male child presented with fever and lowgrade pain in the left ankle region for 3 months. The pain was localized and occurred continuously. Local examination revealed slight tenderness without any redness of overlying skin. Plain X-ray of left tibia revealed a focal lytic lesion surrounded by a sclerotic bone rim, in the metaphyseal region extending upto the growth plate. No pathological fracture was visualized. Epiphysis of ankle joint was normal. Based on the clinical history and radiological picture, a provisional diagnosis of Brodie’s abscess was made and his 99mTc-MDP three phase skeletal scintigraphy was advised to confirm active bone pathology. Bone scan was performed with 20 Mci of 99mTc-MDP intravenously. Dynamic flow and blood pool study of the ankle region was acquired anteriorly. Multiple anterior and posterior static images were acquired 2 hours postinjection followed by SPECT. The nuclear bone scan revealed increased blood perfusion in the left ankle region. Delayed image showed focal increased tracer uptake in the distal end of left tibia. Tracer uptake in the rest of the skeleton was uniform. SPECT reconstruction images also showed focal increased tracer uptake in the distal end of the left tibia. Patient was initially managed with erythrocin in the ward. However, his symptoms were not relieved and patient persistently complained of pain and swelling. Surgical exploration of the lesion was planned. The lesion was curetted completely, abscess was drained and wound was closed. Histopathology of the specimen revealed chronic granulomatous infection with presence of inflammatory cells. No evidence of any benign tumor was seen on histopathology. High dose antibiotics were continued for 2 months. Patient made an uneventful recovery and his pain settled. Presently, she has no pain or any symptom of recurrence." @default.
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• W13522005 date "2008-03-01" @default.
• W13522005 modified "2023-09-23" @default.
• W13522005 title "Brodie's abscess--an uncommon cause of leg pain." @default.
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