Brodie abscess

The patient's leukocyte count was 7.9 x 109/L, with an erythrocyte sedimentation rate of 10 mm/h. He had a negative test result for HIV infection. Radiography of his left distal tibia showed a solitary, punched-out radiolucent lesion in the epiphysis (Figure 1C). A computed tomography scan show...

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Bibliographic Details
Published in:Canadian Medical Association journal (CMAJ) 2017-01, Vol.189 (3), p.E117-E117
Main Authors: Qi, Ruyu, Colmegna, Inés
Format: Article
Language:English
Subjects:
Abscess - diagnostic imaging
Abscess - microbiology
Abscess - therapy
Adult
Ankle
Antibiotics
Bone diseases
Care and treatment
Case studies
Diagnosis
Humans
Male
Osteomyelitis
Osteomyelitis - diagnostic imaging
Osteomyelitis - microbiology
Osteomyelitis - therapy
Practice
Staphylococcal Infections - complications
Staphylococcal Infections - diagnosis
Staphylococcal Infections - therapy
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Summary:The patient's leukocyte count was 7.9 x 109/L, with an erythrocyte sedimentation rate of 10 mm/h. He had a negative test result for HIV infection. Radiography of his left distal tibia showed a solitary, punched-out radiolucent lesion in the epiphysis (Figure 1C). A computed tomography scan showed an irregular, lobular-shaped lucent lesion in the left distal tibia, with a tract communicating with the tibiotalar joint (Figures 1D, 1E). He was diagnosed with Brodie abscess. Brodie abscess is a subacute form of hematogenous osteomyelitis that accounts for 2.5%-42% of primary bone infections.1 In general, patients are younger than 25 years of age and present with joint pain and localized swelling. Signs and symptoms of systemic disease are frequently absent.2,3 Staphylococcus aureus (30%-60%), Pseudomonas (5%), Klebsiella (5%) and coagulasenegative Staphylococcus (5%) are causative organisms.2 However, 20% of cultures are negative for these organisms.2,3 Radiographically, an intramedullary area of central lucency with sclerotic margins is characteristic.4
ISSN:0820-3946
1488-2329
DOI:10.1503/cmaj.151419