UMEM Educational Pearls

Category: Visual Diagnosis

Title: What's the Diagnosis? Case by Dr. Ibrahim H. Abuduruk

Posted: 5/17/2015 by Haney Mallemat, MD (Emailed: 5/19/2015) (Updated: 5/19/2015)
Click here to contact Haney Mallemat, MD

Question

5 year-old with no past medical history, complains of a limp and mild left knee pain. No history of trauma. Physical exam is significant for a low-grade fever and is otherwise normal. What’s the diagnosis?

Answer

Brodie's abscess a.k.a subacute osteomyelitis

  • Form of osteomyelitis, which is difficult to diagnose, and is often mistaken for a tumor.
  • Males are affected more than females and the range of presentation is 2-15 years.
  • Work up is difficult as CBC, ESR, CRP, and blood cultures are inconclusive. Xrays may mimic tumors.
  • Treatment is antibiotics if the diagnosis is obvious; if not, biopsy to make the diagnosis. Surgery an option if either the lesion is aggressive or there is pus extending into the synovial fluid. 

References

Follow me on Twitter (@criticalcarenow) or Google+ (+criticalcarenow)