Identify the condition as shown:
A. Brodie abscess
B. Osteoid osteoma
C. Intracortical hemangioma
D. Chondromyxoid fibroma
Answer. A. Brodie abscess
- Brodie abscess is an intraosseous abscess related to a focus of subacute pyogenic osteomyelitis.
- Unfortunately, there is no reliable way radiographically to exclude a focus of osteomyelitis.
- It has a protean radiographic appearance and can occur at any location and in a patient of any age.
- It might or might not be expansile, have a sclerotic or nonsclerotic border, or have associated periostitis.
- Typically these present in children with unfused epiphyseal plates, more frequently in boys.
It has a predilection for ends (metaphysis) of tubular bones:
- proximal/distal tibial metaphysis (most common)
- carpal and tarsal bones
- Rarely traversing the open growth plate; epiphysis (in children and infants).
- lytic lesion often in an oval configuration that is oriented along the long axis of the bone
- surrounded by a thick dense rim of reactive sclerosis that fades imperceptibly into surrounding bone
- lucent tortuous channel extending toward growth plate prior to physeal closure (pathognomonic)
- periosteal new-bone formation +/- adjacent soft-tissue swelling