Osteomyelitis - Staphylococcus aureus

Case contributed by Fabien Ho
Diagnosis certain

Presentation

Calf swelling after traumatic injury (football) for two months

Patient Data

Age: 12 years
Gender: Male
This study is a stack
Coronal
bone window
This study is a stack
Axial bone
window
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Info

Diaphyseal and metaphyseal anomalies.
Bone marrow replacement, endosteal patchy lytic resorption and periosteal reaction (single-layer, but irregular). Swelling of adjacent tissue.
Bone surgical biopsy left a hiatus in the cortical bone, on the medial side of the diaphysis.

Productive and lytic changes, hence due to a chronic inflammatory process, with bone marrow replacement by a non-osteogenic non-cartilaginous matrix. 

This study is a stack
Coronal
STIR
This study is a stack
Axial
T1
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Coronal T1
C+ fat sat
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Bone marrow replacement by an inflammatory tissue with homogenous enhancement (except fat marrow remnants). Surrounding edema with enhancement.

Case Discussion

Bone surgical biopsy revealed bacterial origin due to Staphylococcus aureus with penton-valentine toxin.
No sign of malignancy.

Growth cartilage is preserved (so far).

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