Chronic femoral diaphyseal osteomyelitis with radiographs initially concerning for Paget disease of the bone

Chronic osteomyelitis can be difficult to diagnose given its similar radiographic appearance to other lesions. This case report describes a 48-year-old woman, who presented with left thigh pain and on radiography a large disorganized sclerotic lesion involving nearly the entire femoral diaphysis, co...

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Bibliographic Details
Main Authors: Seth A. Reasoner, BA, Juan M. Colazo, BSc, Jonathan Tucci, MD, PhD, Justin Cates, MD, PhD, Kathryn M. Dahir, MD
Format: Article
Language:English
Published: Elsevier 2020-04-01
Series:Radiology Case Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S1930043319304078
Description
Summary:Chronic osteomyelitis can be difficult to diagnose given its similar radiographic appearance to other lesions. This case report describes a 48-year-old woman, who presented with left thigh pain and on radiography a large disorganized sclerotic lesion involving nearly the entire femoral diaphysis, concerning for Paget disease or malignancy. Biopsy suggested chronic osteomyelitis but did not identify a causative organism. Treatment with antibiotics led to resolution of pain and improvement of biochemical markers. This case exemplifies the role of radiographic imaging in the diagnosis of chronic osteomyelitis and the possible utility of antibiotics for culture-negative chronic osteomyelitis. We review imaging modalities for the diagnosis of chronic osteomyelitis and Paget disease. Keywords: Chronic osteomyelitis, Paget disease of bone, Bone infection, Metabolic bone disease
ISSN:1930-0433