Adult pseudo-tumor-like subacute osteomyelitis

Abstract

Hematogenous osteomyelitis in adults is rare, and its subacute form is exceptional after the age of 20. It' is usually clinically latent which explains the difficulty of the diagnosis. The first differential diagnosis is bone tumors. It is known for its poor clinical and biological presentation despite a rich radiological aspect. Magnetic resonance imaging (MRI) is the examination of choice to confirm the diagnosis. The main differential diagnosis are primary and secondary bone tumors. The treatment is based on surgery and precise antibiotic therapy. Our patient is 52 years old who had pain in his left thigh, a discrete inflammatory syndrome without fever. He underwent standard X-ray, scintigraphy, and MRI, leading to finding an intraosseous lytic process with rupture of the cortical bone. The diagnosis of staphylococcal osteomyelitis was confirmed thanks to surgical biopsy and bacteriological sample, and his treatment was completed with specific antibiotic therapy.