Intraosseous abscess

Last revised by Dr Henry Knipe on 23 Mar 2022

Intraosseous abscess refers to the pus-filled cavity within the bone with the surrounding rim of granulation tissue 1.

Terminology

The term intraosseous abscess should be used for fluid-signal cavities within the bone showing peripheral rim enhancement or show a penumbra sign or diffusion restriction in unenhanced images. However, in subacute or chronic osteomyelitis the intraosseous abscesses can be termed as Brodie abscess 1.

Radiographic features

Plain radiograph
  • lucent lesion with or without surrounding rim of reactive sclerosis often oriented along the long axis of the bone 2,3
  • periosteal new-bone formation +/- adjacent soft-tissue swelling 2,3
CT
  • hypodense cystic lesion with thick rim ossification, well-circumscribed periosteal reaction, and reactive bone sclerosis around the lesion 2,3
MRI
  • T1: hypointense
  • T2/T2FS/STIR: hyperintense
  • T1 C+: peripheral enhancement
  • DWI: diffusion restriction 2,3

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Cases and figures

  • Case 1: femur osteomyelitis and abscess
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