Chronic osteomyelitis

Case contributed by Bassem Marghany
Diagnosis certain

Presentation

Chronic left arm pain. History of surgery 1 month back for debridement of chronic osteomyelitis.

Patient Data

Age: 35 years
Gender: Male
ct
This study is a stack
Coronal
bone window
This study is a stack
Sagittal
bone window
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Axial bone
window
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3D Volume
Rendering
This study is a stack
Coronal
Soft tissue
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AP & Lat
Old X-ray
This study is a stack
Sagittal bone
window Old CT
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Info

Diffuse thickening and remodelling of the humeral shaft. Small healing cloaca at the distal humeral shaft.

Another larger more distal surgical track, with a sclerotic bone fragment seen within (bony sequestrum).

Case Discussion

The patient presented for follow-up after surgical debridement 1 month back for chronic osteomyelitis.

He had presented 3 months earlier at another hospital with chronic pain of the left arm for 2 months, not responding to analgesics; No history of trauma, significant medical illness or comorbidities.

X-ray and CT (old studies in this case) and lab tests were done. The patient received IV antibiotics and was submitted for surgical debridement where histopathological verification of osteomyelitis was achieved.

The newly developed bony sequestrum may act as a nidus for infection and hence usually requires excision if a cure is to be achieved.

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