EURORAD ESR

Case 926

Brodie’s Abscess (Cystic Osteomyelitis)

Author(s)
P. Peene, A. Yasar, C. Dierickx, P. Van Wanghe
 
Patient
male, 42 year(s)
 
 
  • Figure 1
    Conventional radiograph of the right knee

    Conventional radiograph of the right knee, lateral view shows an ill-defined radiolucent area at the distal metaphysis of the femur. Radiolucency is pronounced at the small focus just proximal to the physis (arrow),...

     
    Area of Interest: unknown; Imaging Technique: Conventional radiograph of the right knee;
     
     
  • Figure 2
    Axial CT scan of the right knee

    Axial CT scan of the right knee visualizes multifocal osteolytic areas in the bone marrow and the traject of the cortical fistula (arrow).

     
    Area of Interest: unknown; Imaging Technique: Axial CT scan of the right knee;
     
     
  • Figure 3
    MRI of the knee
     

    MRI of the right knee shows on the sagittal SE T1-weighted MR-image a large hypointense area bordered by slight hyperintense rim at the distal femur (arrowhead), hypointense surrounding bone marrow, suggesting...

     
    Area of Interest: unknown; Imaging Technique: MRI of the knee;

    Sagittal Gadolinium-enhanced SE T1-weighted MR-image demonstrates pronounced enhancement of the peripheral rim, no enhancement at the center of the lesion, enhancement in the area of surrounding intraosseous edema...

     
    Area of Interest: unknown; Imaging Technique: MRI of the knee;

    Axial TSE T 2 -weighted MR-image shows a uniform, hyperintense intraosseous area, indicating fluid collection, communicating with the paraosseous infiltrated fat through a transcortical fistula (arrowhead).

     
    Area of Interest: unknown; Imaging Technique: MRI of the knee;
     
     
Conventional radiograph of the right knee, lateral view shows an ill-defined radiolucent area at the distal metaphysis of the femur. Radiolucency is pronounced at the small focus just proximal to the physis (arrow), but subtle at the area surrounding this focus (region out-lined by small arrows).
 
Axial CT scan of the right knee visualizes multifocal osteolytic areas in the bone marrow and the traject of the cortical fistula (arrow).
 
MRI of the right knee shows on the sagittal SE T1-weighted MR-image a large hypointense area bordered by slight hyperintense rim at the distal femur (arrowhead), hypointense surrounding bone marrow, suggesting edema, and diffuse infiltration of the paraosseous fat posterior to the femoral shaft (arrow).
 
Sagittal Gadolinium-enhanced SE T1-weighted MR-image demonstrates pronounced enhancement of the peripheral rim, no enhancement at the center of the lesion, enhancement in the area of surrounding intraosseous edema and paraosseous fat infiltration. A cortical fistula (arrow) is clearly demonstrated.
 
Axial TSE T 2 -weighted MR-image shows a uniform, hyperintense intraosseous area, indicating fluid collection, communicating with the paraosseous infiltrated fat through a transcortical fistula (arrowhead).
 
 
 
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