Brodie's abscess of the lower tibia

Case contributed by Essam G Ghonaim


Anterior lower left leg pain of several months duration, no past history of trauma or operations

Patient Data

Age: 20 years
Gender: Male

There is an oval shaped well defined intra-medullary lytic lesion involving meta-diaphyseal region of lower tibia. It is seen surrounded by an irregular sclerosis. No cortical breaching and no periosteal reaction. 


An irregular yet well defined intra-medullary non-expanding lesion of abnormal signal intensity is seen involving the meta-diaphysis of the lower tibia. It has a small projection heading towards the growth plate (arrows).

The lesion shows the classic penumbra sign


Case Discussion

Finger-like extension from the abscess directing towards the epiphyseal plate is said to be pathognomonic and indicates infection tunneling 1 and this communication with the epiphysis is one of the what-does-the-clinician-want-to-know signs 2


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