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Case Reports
. 2020 Jun 13;12(6):e8592.
doi: 10.7759/cureus.8592.

A Case of Brodie's Abscess With Tibial Erosion and Extravasation Into Surrounding Soft Tissue

Josh Lowe  1 , Rachel E Bridwell  2 , Aaron G Matlock  2 , Amber Cibrario  3 , Joshua Oliver  2
Affiliations
Case Reports

A Case of Brodie's Abscess With Tibial Erosion and Extravasation Into Surrounding Soft Tissue

Josh Lowe et al. Cureus. .

Abstract

Atraumatic limb pain and limp is a common pediatric presentation in the emergency department in the United States. In a majority of cases, these presentations are benign. However, in cases where pediatric patients are repeatedly presenting for atraumatic limb pain, further investigation is required. We present such the case of a 14-year-old female with acute worsening of progressive atraumatic knee pain who was found to have a Brodie's abscess, a subacute pyogenic form of osteomyelitis. This is a particularly challenging diagnosis, as it often presents with no associated symptoms such as fever or weight loss. The consequences of missing this diagnosis include permanent disability and potential amputation, but excellent outcomes can be expected for those who undergo timely surgical debridement and irrigation. We discuss the etiology, common presentations, and treatment of this rare but potentially limb-threatening disease in the hope that clinicians will consider this diagnosis in cases of persistent or progressive atraumatic limb pain.

Keywords: atraumatic limp; brodie's abscess; pyogenic osteomylitis.

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Conflict of interest statement

The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army, the Department of the Air Force, or the Department of Defense or the U.S. Government.

Figures

Figure 1
Figure 1. Lateral radiograph, with arrow demonstrating a lucency in the proximal right tibia.
Figure 2
Figure 2. Longitudinal view of the proximal tibia demonstrating fluid collection, with arrow showing large septation (later demonstrated to be fascia) on bedside ultrasound.
Figure 3
Figure 3. (A) Coronal view of T1 MRI with contrast demonstrating Brodie’s abscess in the right proximal femur. (B) Axial view of T1 MRI with contrast demonstrating Brodie’s abscess in the right proximal femur with a break in the cortex and extravasation into the surrounding tissue.
See this image and copyright information in PMC

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