Image Based Question – 74388

The following X-ray was taken of a 16 years old patient. What is the most likely pathology seen?

A. Ewing’s sarcoma

B. Osteosarcoma

C. Chronic osteomyelitis

D. Acute osteomyelitis

Correct Answer » C Explanation

Ans: C. Chronic osteomyelitis

• Radiological feature & age is suggestive of chronic osteomyelitis.

Chronic osteomyelitis:

• Weeks or months after the onset of acute infection a sequestrum appears in the follow-up x-ray and the patient is left with a chronic infection and a draining sinus.

Investigations:

• X-ray: Bone resorption with thickening & sclerosis, pieces of dead bone (sequestra) & form of a distinct bony sheath (involucrum).
• Radioisotope scintigraphy is sensitive but not specific, useful for showing up hidden foci of infection.