Deep Bone Abscess After Pin Tract Infection of an Operatively Treated Supracondylar Humeral Fracture.

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Abstract

Conflict of interest statement: Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. 5. Rev Chil Pediatr. 2020 Dec;91(6):947-952. doi: 10.32641/rchped.vi91i6.1752. Epub 2020 Dec 1. [Brodie's abscess, a pathology difficult to diagnose]. [Article in Spanish] Silva C I(1), Figueroa G MJ(2), Cañete C I(2), Hodgson O F(2), Gündel P A(2). Author information: (1)Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. (2)Departamento de Traumatología y Ortopedia, Hospital Clínico, Universidad Católica de Chile, Santiago, Chile. INTRODUCTION: Acute osteoarticular infections in children are rare pathologies, therefore early diagnosis and prompt treatment are crucial to avoid acute and long-term complications. Brodie's abscess (BA) is an un common type of subacute osteomyelitis, difficult to diagnose, so clinical suspicion is essential. Ob jective: To describe a case of Brodie's abscess and its etiological and clinical features. CLINICAL CASE: A 14-year-old patient was seen at our clinic, who reported a one-month pain in the right thigh, with no history of fever or trauma. Physical examination revealed no volume increase, painful right hip range of motion, and increased sensitivity on superficial palpation of the right iliotibial band. X-rays where normal. Because of the pain persistence, an ultrasound was requested which showed a cortical irregularity. Magnetic resonance imaging (MRI) was performed and revealed a right femoral diaphysis, due to a possible bone tumor or an infectious process. Lab tests were normal. Biopsy and cultures were collected, identifying multi-sensitive Staphylococcus aureus. He was managed with debridement and intravenous antibiotics, responding positively. CONCLUSIONS: The BA's clinical features and lab tests are unspecific, therefore the non-specialist physician should strongly suspect this pathology as a possible differential diagnosis in patients who persist with pain and present imaging alterations, even when there are no other symptoms or normal inflammatory parameters. A bone biopsy is essential for the differential diagnosis of tumor pathologies. DOI: 10.32641/rchped.vi91i6.1752