|Case 11 :|
|Young patient with chronic knee pain. X-ray and MRI are available for diagnosis.|
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Brodie's abscess is a localized form of chronic osteomyelitis, and is very common in children, due to high vascularity of the metaphysis and growth plates. Metaphyseal locations are most common before closure of the growth plates. After closure, a meta-epiphyseal abscess is most frequent. When not hematogeneous in etiology, they occur most frequently in young adults in the long bones of the lower extremities.
Pathologically, the wall of the abscess contains large amounts of granulation
tissue, accounting for pronounced rim enhancement on contrast-enhanced
MRI or CT scans. The central portions mainly contain necrotic fluid and
pathologic organisms. Staphylococcus aureus is cultured in half of the
cases. The abscess is commonly surrounded by inflammatory changes and
edema of adjacent bone marrow. Tran cortical fistulization may lead to
soft tissue spread.
Dr. Ashok Raghavan, Manipal Hospital, Bangalore