Radial osteomyelitis

Case contributed by Dr Jeremy Jones

Presentation

Wrist pain and reduced range of motion. No history of trauma.

Patient Data

Age: 5 years
Gender: Female
X-ray

Lucency centered on the ulnar margin of the radial metaphysis. There is widening of the physis. Appearances are most in keeping with infection.

X-ray

Follow up imaging 8 years later

Follow up imaging 8 years later shows deformity centered on the distal radius. There has been development of a bony bar and growth disturbance.

MRI

The bony bar is clearly seen on this T1 weighted sequence.

Case Discussion

Metaphyseal lucency is often the result of infection and this should be actively considered. Raised inflammatory markers and systemic upset are helpful keys to making the diagnosis.

Ultrasound may demonstrate a joint effusion or subperiosteal collection. MRI is more sensitive for these findings and may also demonstrate medullary edema or reactive soft-tissue inflammatory change.

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Case information

rID: 62738
Published: 30th Aug 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: NHS Lothian

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