Brodie’s abscess revisited

P R Kornaat,M Camerlinck,H M Kroon,F M Vanhoenacker,G De Praeter

doi:10.5334/jbr-btr.145

Abstract

Radiology plays an important role in the diagnosis of a Brodie's abscess, as can be difficult for a clinician to identify the disease using clinical information alone. A Brodie's abscess is clinically difficult to diagnose because patients typically have mild local symptoms, few or no constitutional symptoms, and near normal laboratory values. Furthermore, a Brodie's abscess may mimic various benign and malignant conditions, resulting in delayed diagnosis and treatment. The most frequently made incorrect diagnosis is that of a primary bone tumor. The present pictorial review summarizes imaging clues to the diagnosis of a Brodie's abscess, such as the serpentine sign on conventional radiographs and the penumbra sign seen on Magnetic Resonance (MR) images. A Brodie's abscess is difficult to diagnose, however, once diagnosed, it is a curable disease with a 100% cure rate.

Highlights

Radiology plays an important role in the diagnosis of a Brodie’s abscess, as can be difficult for a clinician to identify the disease using clinical information alone
George’s Hospital, London, United Kingdom (Fig. 1). He amputated the leg of a man who had intractable pain for a number of years
An osseous infection can be caused by haematogenous spread of organ

Summary

The causative organism is usually

Salmonella, in patients with diabetes mellitus or sickle cell anemia. Haemophilus influenza, Kingella kingae, Mycobacterium tuberculosis, Spirochaetes, Fungi (Candida, Actinomyces), Viruses and Helminths (e.g. Echinococcus) are described. 18 months, when one considers that vascular communication between the epiphysis and metaphysis is present until the age of 18 months, as described by Trueta [4]. Another interesting explanation for the localization of subacute osteomyelitis adjacent to the growth plate cartilage is the finding by Speers and. The images show a typical Brodie’s abscess in the distal metaphysis of the tibia. It contains a small central area with low signal intensities on all sequences, compatible with a sequestrum. On these axial images a “guirlande” shaped appearance of the Brodie’s abscess is appreciated

Clinical Presentation

Differential diagnosis

Findings

4IÈME SYMPOSIUM DE SÉNOLOGIE Oostduinkerke