Osteomyelitis

Abstract

The clinical features and images of osteomyelitis can look like a bone tumor. A differential diagnosis must sometimes be made from local osteolytic lesions and malign bone tumors.

Although the diagnosis of osteomyelitis can be well defined, some cases can propose a differential diagnosis from a bone tumor [2].

Brodie’s abscess: this is a subacute osteomyelitis with most cases located in the metaphysis of long bones (tibia, femur) [1, 3]. It is a monostotic lytic lesion surrounded with sclerosis, with few inflammatory signs and frequently the germen is not found (bacteriological and histological studies must be made).

Some other cases can show a periosteal reaction wich looks like an onion bulb, confusing it with a bone tumor such as Ewing’s sarcoma or osteosarcoma mostly seen in children or adolescents [4] (Fig. 27.1).

Fig. 27.1

Periosteal reaction