Presentation
On a school trip to a local city farm. Ankle pain. No history of trauma.
Patient Data
Age: 8 years
Gender: Male
From the case:
Osteomyelitis with sequestrum
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Lucency of the medial aspect of the tibial metaphysis. The abnormality extends to the epiphysis. No soft tissue mass. No periosteal reaction. Differentials include a primary bone tumor or infection.
From the case:
Osteomyelitis with sequestrum
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Bone edema throughout the distal tibia. Abnormality extends to the epiphysis. The medial portion of the physis is very abnormal. The majority of the edematous marrow enhances but there are central areas of non-enhancement. Reactive soft-tissue edema.
From the case:
Osteomyelitis with sequestrum
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Grossly abnormal metaphysis that extends to the epiphysis. The central non-enhancing portion on the MRI represents a bony sequestrum. Appearances are of complicated osteomyelitis with sequestrum.
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