Brodie abscess: reappraisal

Abstract

Upon review, 25 cases of Brodie abscess demonstrated a radiological spectrum not previously appreciated. One third of the lesions were diaphyseal in location, and 50% had associated cortical thickening, while 40% showed a stimulated periosteal reaction, and 20% contained sequestra. The variable radiological appearance was underscored by the fact that the preoperative diagnosis was other than osteomyelitis in half the cases. A diverse nomenclature has proliferated to describe and catalogue bone abscess formation. Although the radiological spectrum is broad, the unanimity of clinical presentation, pathological findings, and response to surgical excision supports the concept of a single entity with variable expression.