Post-traumatic Brodie's Abscess of the Tarsal Cuboid: A Case Report and Review of the Literature

Abstract

Brodie's abscess of the tarsal cuboid is a relatively rare presentation of this disease. In this study, we present the case of a 20-year-old male with post-traumatic Brodie's abscess of the tarsal cuboid that was left untreated for three years after the traumatic episode (penetrating injury with a sharp piece of wood). The patient presented pain over the injured area, limping, while plain foot radiographs showed a small lytic cavitary area in the cuboid. The magnetic resonance imaging revealed the presence of the abscess in a 2-cm diameter cavity in the cuboid bone and chronic inflammation of the surrounding plantar musculature. The treatment regime included curettage of the cavity, debridement of the inflammatory tissues, and administration of antibiotics, according to the cultures harvested intraoperatively, for six weeks. During this period, symptoms completely resolved.

Keywords: brodie's abscess; chronic sub-acute osteomyelitis; curettage; escherichia coli; infection; penetrating trauma; tarsal cuboid.

Figure 1. (A) Anteroposterior (AP) and oblique view radiographs; (B) CT scan of the right foot

A well-defined osteolytic cavitary lesion in the tarsal cuboid is revealed (arrows).

Figure 2. (A) Transverse T1-weighted MRI image; (B) coronal T2-weighted MRI image

Cavitary lesion in the tarsal cuboid with high signal intensity margins and low signal intensity in the center (arrows)

Figure 3. Bone window opening to the superior aspect of the tarsal cuboid

Figure 4. Cavity opened, excised, and lavaged

Figure 5. Foreign body (probably shoe sole remnant) removed from the tarsal cuboid bone cavity

Figure 6. (A) Anteroposterior (AP) view radiograph; (B) oblique view radiographs

Partial new bone formation in the cavity of the tarsal cuboid of the right foot.