Osteomyelitis of the ulna caused by Porphyromonas gingivalis

Abstract

A 41-year-old man was provided with a jacket crown after a root end resection of a molar. Four months later, cortical destruction of the ulnar diaphysis with swelling and pain appeared in his forearm. No microorganism could be grown from an intraoperative tissue specimen, but bacterial 16S rRNA genes were detected by broad-range PCR, revealing Porphyromonas gingivalis as the causative agent of osteomyelitis.

FIG. 1.

(a) MRI shows cortical destruction and contrast enhancement in the bone and surrounding soft tissue. (b) Skeletal scintigraphy with a high level of nuclide uptake in the middle of the right ulna. (c) CT scan showing a cortical defect and small sequestrum centrally. (d) X ray taken 2 months after the operation shows consolidation with bone apposition. R, right.