Brodie abscess of the tibia

Case contributed by Dr George Harisis

Presentation

Several months of persistent right knee pain, intermittent night sweats and elevated WCC. History of osteomyelitis.

Patient Data

Age: 13 years
Gender: Male
CT

CT right knee

Unenhanced CT of the right knee demonstrates a lucent ovoid lesion centered at the proximal tibial metaphysis and extending into the epiphyseal plate. There is a narrow zone of transition with somewhat sclerotic borders and a central calcific focus. A draining tract extends anteriorly through the physis to the tibial tuberosity. 

Comment:

The findings are consistent with a Brodie abscess.

Case Discussion

This is a classic example of a Brodie abscess of chronic osteomyelitis which most commonly affects the tibial metaphysis1. The medullary lesion can harbor a focus of demineralized bone (sequestrum) which may become surrounded by dense periosteal new bone (involucrum).  A draining tract (cloaca) provides a means of decompressing the abscess cavity2.

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Case information

rID: 58984
Published: 15th Mar 2018
Last edited: 6th Mar 2019
Inclusion in quiz mode: Included

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