Friday 22 June 2012

58.REGARDING BRODIES ABCESS TRUE IS

A.FAVOURITE SITE- DIAPHYSIS
B.TYPE OF OSTEOMYELITIS
C.INTERMITTENT PAIN AND SWELLING
D.MOST OFTEN REQUIRES EXCISION

ANS:TYPE OF OSTEOMYELITIS


A Brodie abscess is a subacute osteomyelitis, which may persist for years before converting to a frank osteomyelitis. Classically, this may present after conversion as a draining abscess extending from the tibia out through the shin.

Most frequent causative organism is Staphylococcus aureus.

Clinical Presentation

Localized pain, often nocturnal, alleviated by aspirin. Often mimics the symptoms of Osteoid osteoma, which is typically < 1 cm diameter.

Most Frequent Sites

Usually occurs at the metaphysis of long bones. Distal tibia, proximal tibia, distal femur, proximal or distal fibula, and distal radius.

Radiographic Features

Oval, elliptical, or serpiginous radiolucency usually >1 cm surrounded by a heavily reactive sclerosis, granulation tissue, and a nidus often less than 1 cm. The margins often appear scalloped on radiograph. Brodie's abscess is best visualized using Computed tomography (CT) scan. Associated atrophy of soft tissue near the site of infection and shortening of the affected bone. Osteoblastoma may be a classic sign for Brodie's abscess.

History

Brodie abscess is named after Sir Benjamin Collins Brodie, 1st Baronet

Treatment

Mainly surgical approach has to be taken. If cavity is small then surgical evacuation & curettage is performed under antibiotic cover. If cavity is large then after evacuation, packing with cancellous bone chips



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