Brodie abscess

Brodie abscess is an intraosseous abscess related to a focus of subacute pyogenic osteomyelitis. Unfortunately, there is no reliable way radiographically to exclude a focus of osteomyelitis. It has a protean radiographic appearance and can occur at any location and in a patient of any age. It might or might not be expansile, have a sclerotic or nonsclerotic border, or have associated periostitis

Typically these present in children, more frequently in boys. 

Aetiology 
  • S. aureus (most common); cultures often negative
Location

It has a predilection for ends (metaphysis) of tubular bones:

  • proximal/distal tibial metaphysis (most common)
  • carpal and tarsal bones

Rarely traversing the open growth plate; epiphysis (in children and infants).

Plain radiograph 
  • lytic lesion often in an oval configuration that is oriented along the long axis of the bone
  • surrounded by a thick dense rim of reactive sclerosis that fades imperceptibly into surrounding bone
  • lucent tortuous channel extending toward growth plate prior to physeal closure (pathognomonic)
  • periosteal new-bone formation +/- adjacent soft-tissue swelling
  • may persist for many months
CT
  • central intramedullary hypodense cystic lesion with thick rim ossification
  • extensive thick well-circumscribed periosteal reaction and bone sclerosis around  the lesion could be seen
MRI

It has been showed that the “penumbra sign” on magnetic resonance (MR) imaging is useful for discriminating subacute osteomyelitis from other bone lesions. The penumbra sign is a rim lining of an  abscess cavity  with  higher  signal  intensity  than  that of  the main abscess on T1-weighted images

Share Article

Article Information

rID: 1019
Section: Pathology
Synonyms or Alternate Spellings:
  • Subacute pyogenic osteomyelitis
  • Smoldering indolent infection
  • Brodie's abscess
  • Brodie abscesses

Support Radiopaedia and see fewer ads

  • Drag
    Brodie abscess
    Case 1
    Drag here to reorder.
  • Drag
    Brodie's abscess
    Case 2: plain film
    Drag here to reorder.
  • Drag
    Case 2: MRI
    Drag here to reorder.
  • Drag
    Case 3
    Drag here to reorder.
  • Drag
    Case 4
    Drag here to reorder.
  • Drag
    Case 5
    Drag here to reorder.
  • Drag
    Case 6
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.