Brodie abscess of the knee - pediatric

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Painful left knee with fever, restricted motions and raised inflammatory markers (CRP and ESR).

Patient Data

Age: 9 years
Gender: Male

Small intraosseous abscess (Brodie abscess) with peripheral enhancement of the posteromedial aspect of the femoral epiphysis with adjacent cortical breach and thickening with the enhancement of the adjacent soft tissues. Extensive bone marrow edema with of low signal on T1 and high signal on PD fat sat with enhancement of the mid and medial aspect of the femoral epiphysis. Enlarged lymph nodes at the popliteal fossa.

Mild joint effusion.

Annotated image

Annotated images:

  • green arrow indicates the Brodie abscess
  • red arrow indicates the cortical breach

Case Discussion

The clinical presentation and the MRI features are most consistent with a Brodie abscess.

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