Age: 1 month
Sex: Female
Indication: Fever, leg swelling
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Case #4
Findings
- Extensive bone destruction involving the medial two-thirds of the distal femoral metaphysis with possible additional involvement of the medial aspect of the epiphysis
- Soft tissue extension adjacent to the osseous destructive changes with developing heterotopic ossification
- Periosteal reaction along the femoral shaft with faint periosteal reaction along the proximal tibia
- No acute fracture or malalignment
Diagnosis
- Osteomyelitis
Sample Report
Extensive bone destruction involving the medial two-thirds of the distal femoral metaphysis with possible additional involvement of the medial aspect of the epiphysis and periosteal reaction along the femoral shaft. Findings are most concerning for osteomyelitis, particularly given the clinical history. Associated septic arthritis of the knee cannot be excluded on this study. Consider MRI for further evaluation.
Soft tissue extension adjacent to the osseous destructive changes with developing heterotopic ossification. MRI could also evaluate for associated soft tissue abscess.
Faint periosteal reaction along the proximal tibia may be reactive; however, infectious involvement of the tibia is not excluded.
No acute fracture or malalignment.
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