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 member1mo ago
most likely an osteoid osteoma considerign the pain relief by nsaids but could be infection
Child with deep leg pain — what is this lesion? — Community Case | OrthoVellum
