Chronic osteomyelitis of the right femur

Case contributed by Bahman Rasuli
Diagnosis certain

Presentation

Fistulogram in chronic posttraumatic osteomyelitis.

Patient Data

Age: 60 years
Gender: Male
Fluoroscopy

A catheter is introduced into the fistula under sterile conditions, and an undiluted iodinated contrast medium is injected. The flow of the contrast medium is documented by fluoroscopy, and spot radiographs are taken in several different planes

A fistulous tract in the soft tissue extending into a collection and subsequently terminated into the round radiolucent bone defect in the distal femur suggestive for soft tissue collection and cloaca formation respectively

Well defined radiolucent round lesion at the distal of the right femur due to cloaca formation

Pronounced, inhomogeneous bone marrow sclerosis at the site of the femur defect.

Case Discussion

Fistulogram can determine the communication between the fistula and bone or may detect a collection cavity or sequestrum formation. 

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