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Case Reports
. 2024 Jul:120:109865.
doi: 10.1016/j.ijscr.2024.109865. Epub 2024 Jun 8.

Treatment of a Brodie's abscess manifesting as persistent pain after a twisting ankle injury: A case report

Hakam Alasaad  1 , Doried Diri  2 , Hassan ALSamman  1 , Jaber Ibrahim  1
Affiliations
Case Reports

Treatment of a Brodie's abscess manifesting as persistent pain after a twisting ankle injury: A case report

Hakam Alasaad et al. Int J Surg Case Rep. 2024 Jul.

Abstract

Introduction: Cystic lesions in long bones are the radiological presentation of various bone pathologies, they can easily be misdiagnosed and thus mistreated; treatment varies from observation to aggressive surgical interventions based on the nature and characteristics of the lesion.

Case presentation: A 25-year-old male had a twisting injury to his ankle and his radiographs showed a cystic lesion in the distal tibia that was asymptomatic until he injured his ankle. he had persistent pain since then. and after conservative methods failure, a two-stage surgical intervention was done; first, we curetted the lesion and filled it with antibiotics cement; then the cement was removed with autologous bone grafting. The patient eventually healed and returned to his normal activity level.

Discussion: Brodie's abscess has a similar radiological appearance to other bone neoplasms and tumor-like lesions. Clinically, it is minimally symptomatic, and often initially misdiagnosed; surgical treatment is very effective, but it depends on the size, location, and aggressiveness of the lesion; the goal is to eliminate the infection, refill the residual gap, and restore the normal function, especially in weight-bearing bones.

Conclusion: Brodie's abscess is a hideous lesion that is hard to diagnose. It could mimic other tumor-like lesions. However, applying bone cement and a second stage of bone grafting might help maximize the treatment efficiency.

Keywords: Bone cement; Case report; Cystic lesions; Infection.

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Conflict of interest statement

Declaration of competing interest The author has no conflicts to disclose.

Figures

Fig. 1
Fig. 1
Preoperative clinical and radiological images.
Fig. 2
Fig. 2
Intraoperative images from the first surgery: a: clinical image of the curetted lesion, b: intraoperative X-rays, c: the curettage material, d: a clinical image after filling the void with antibiotic bone cement.
Fig. 3
Fig. 3
Follow-up anteroposterior and lateral X-rays 6 weeks after the surgery.
Fig. 4
Fig. 4
Intraoperative clinical and radiological images of the sec1ond surgery.
Fig. 5
Fig. 5
Follow-up radiographs 9 months after the last surgery showing full healing of the graft.
See this image and copyright information in PMC

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