AP radiograph of the distal tibia showing an oval lucent metaphyseal lesion with a sclerotic rim
The case
A child presents with several weeks of deep distal leg pain, worse at night and eased by anti-inflammatories. This is the radiograph. What is your differential and next step?
Reveal the model answertap to expand
A well-defined lucent metaphyseal lesion with a sclerotic rim — a Brodie’s abscess (subacute osteomyelitis). Confirm with MRI, send inflammatory markers, and treat with antibiotics with surgical drainage of a walled-off collection.
Night pain eased by NSAIDs also suggests osteoid osteoma — compare
Brodie’s abscess = subacute osteomyelitis
MRI characterises; drainage plus antibiotics for an abscess
Discussion (1)
Community member7d ago
most likely an osteoid osteoma considerign the pain relief by nsaids but could be infection
