Limits...
Brodie's abscess following percutaneous fixation of distal radius fracture in a child.

Rajakulendran K, Picardo NE, El-Daly I, Hussein R - Strategies Trauma Limb Reconstr (2016)

Bottom Line: The index surgery was complicated by a pin site infection that was treated successfully with antibiotics.Previous trauma or surgery has been implicated as predisposing factors.Ours is the first reported case in an adolescent.

View Article: PubMed Central - PubMed

Affiliation: Basildon and Thurrock University Hospitals NHS Foundation Trust, Nethermayne, Essex, SS16 5NL, UK.

ABSTRACT
We report the case of a Brodie's abscess presenting five and a half years following closed reduction and percutaneous pinning of a distal radius fracture. The index surgery was complicated by a pin site infection that was treated successfully with antibiotics. The patient represented with forearm pain years later, and radiological investigations revealed a Brodie's abscess in the distal radius at the site of the previous Kirschner wires. The Brodie's abscess was managed through surgical curettage and antibiotics. Staphylococcus aureus and diphtheroid organisms were cultured from the intraoperative specimens. A Brodie's abscess is a form of localised subacute osteomyelitis, which usually occurs in the metaphysis of long bones and can mimic malignancy. Previous trauma or surgery has been implicated as predisposing factors. We have only identified one previously reported case of Brodie's abscess following percutaneous pinning. Ours is the first reported case in an adolescent. The aim of this paper is to raise awareness of this rare complication and review the current literature.

No MeSH data available.


Related in: MedlinePlus

MRI scan of the left distal radius showing cystic lesions in the distal radius with surrounding oedema and an area of cortical discontinuity
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4814380&req=5

Fig3: MRI scan of the left distal radius showing cystic lesions in the distal radius with surrounding oedema and an area of cortical discontinuity

Mentions: The patient was asymptomatic until the representation five and a half years later. He had no co-morbidities and took no regular medication. Examination revealed a firm tender swelling on the dorsal aspect of the forearm with no surrounding erythema or skin changes. He demonstrated a full range of movement in the wrist and elbow joints with no irritability. There was no associated neurovascular deficit and he was afebrile. Blood tests showed a raised C-reactive protein of 10 and a normal white blood count. A plain radiograph of the forearm revealed a lytic lesion in the distal radial diaphysis, with an ill-defined edge, wide zone of transition and evidence of cortical expansion and periosteal reaction (Fig. 2). The patient underwent a contrast-enhanced magnetic resonance imaging (MRI) scan that demonstrated two discrete fluid-filled lesions in the distal radius (measuring 2.0 cm × 0.9 cm and 1.1 cm × 0.5 cm), with surrounding bone marrow and soft tissue oedema (Fig. 3). A computer tomography (CT) scan confirmed the lucent area, with cortical thickening and an area of cortical discontinuity (Fig. 4). The scans were discussed with the regional bone and soft tissue sarcoma unit. The opinion was that the images were consistent with a Brodie’s abscess in the radius, with inflammatory changes extending across the growth plate and a small dorsal periosteal abscess at the site of the break.Fig. 2


Brodie's abscess following percutaneous fixation of distal radius fracture in a child.

Rajakulendran K, Picardo NE, El-Daly I, Hussein R - Strategies Trauma Limb Reconstr (2016)

MRI scan of the left distal radius showing cystic lesions in the distal radius with surrounding oedema and an area of cortical discontinuity
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4814380&req=5

Fig3: MRI scan of the left distal radius showing cystic lesions in the distal radius with surrounding oedema and an area of cortical discontinuity
Mentions: The patient was asymptomatic until the representation five and a half years later. He had no co-morbidities and took no regular medication. Examination revealed a firm tender swelling on the dorsal aspect of the forearm with no surrounding erythema or skin changes. He demonstrated a full range of movement in the wrist and elbow joints with no irritability. There was no associated neurovascular deficit and he was afebrile. Blood tests showed a raised C-reactive protein of 10 and a normal white blood count. A plain radiograph of the forearm revealed a lytic lesion in the distal radial diaphysis, with an ill-defined edge, wide zone of transition and evidence of cortical expansion and periosteal reaction (Fig. 2). The patient underwent a contrast-enhanced magnetic resonance imaging (MRI) scan that demonstrated two discrete fluid-filled lesions in the distal radius (measuring 2.0 cm × 0.9 cm and 1.1 cm × 0.5 cm), with surrounding bone marrow and soft tissue oedema (Fig. 3). A computer tomography (CT) scan confirmed the lucent area, with cortical thickening and an area of cortical discontinuity (Fig. 4). The scans were discussed with the regional bone and soft tissue sarcoma unit. The opinion was that the images were consistent with a Brodie’s abscess in the radius, with inflammatory changes extending across the growth plate and a small dorsal periosteal abscess at the site of the break.Fig. 2

Bottom Line: The index surgery was complicated by a pin site infection that was treated successfully with antibiotics.Previous trauma or surgery has been implicated as predisposing factors.Ours is the first reported case in an adolescent.

View Article: PubMed Central - PubMed

Affiliation: Basildon and Thurrock University Hospitals NHS Foundation Trust, Nethermayne, Essex, SS16 5NL, UK.

ABSTRACT
We report the case of a Brodie's abscess presenting five and a half years following closed reduction and percutaneous pinning of a distal radius fracture. The index surgery was complicated by a pin site infection that was treated successfully with antibiotics. The patient represented with forearm pain years later, and radiological investigations revealed a Brodie's abscess in the distal radius at the site of the previous Kirschner wires. The Brodie's abscess was managed through surgical curettage and antibiotics. Staphylococcus aureus and diphtheroid organisms were cultured from the intraoperative specimens. A Brodie's abscess is a form of localised subacute osteomyelitis, which usually occurs in the metaphysis of long bones and can mimic malignancy. Previous trauma or surgery has been implicated as predisposing factors. We have only identified one previously reported case of Brodie's abscess following percutaneous pinning. Ours is the first reported case in an adolescent. The aim of this paper is to raise awareness of this rare complication and review the current literature.

No MeSH data available.


Related in: MedlinePlus