UMEM Educational Pearls

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

Posted: 5/17/2015 by Haney Mallemat, MD (Updated: 5/19/2015)
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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

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