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A Rare Case of Brodie's Abscess in the Tibial Diaphysis Masquerading as a Vaso-occlusive Sickle Crisis
Amin, Shefali Shrestha, Manish Amin, Sahil Amin, Suril DiPastina, Katherine
Amin, Shefali
Shrestha, Manish
Amin, Sahil
Amin, Suril
DiPastina, Katherine
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Journal article
Date
2024-01-12
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Podiatric Surgery
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https://doi.org/10.55729/2000-9666.1299
Abstract
We present the case of a 19-year-old male with a history of sickle cell anemia who presented to the hospital with
worsening lower extremity pain. Given his acute presentation and history of recurrent pain crises, he was admitted to the
hospital for management of a suspected acute pain crisis. However, due to continued pain, imaging was obtained which
revealed a different diagnosis for the cause of his symptoms. MRI of the left lower leg revealed heterogenous T1 and T2
hyperintense signals within the proximal tibial diaphysis measuring 6.6 £ 1.6 £ 2.2 cm with a thick rim of peripheral
irregular enhancement with surrounding periosteal reaction and soft tissue edema, concerning for osteomyelitis and
developing Brodie's abscess. The patient underwent tibia irrigation and debridement with the placement of vancomycin
and tobramycin beads. Perioperatively, no purulence was noted within the soft tissues, and no organisms were grown on tissue cultures. The patient's pain improved and he was discharged home with a plan to complete six weeks of intravenous antibiotics. This case represents the need to differentiate Brodie's abscess from a sickle cell crisis. Clinicians should also be aware that patients with sick cell disease are prone to Brodie's abscess and it should be a differential for symptoms of relenting bone pain.
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Citation
Amin, Shefali; Shrestha, Manish; Amin, Suril; Amin, Sahil; and DiPastina, Katherine (2024) "A Rare Case of Brodie’s Abscess in the Tibial Diaphysis Masquerading as a Vaso-occlusive Sickle Crisis," Journal of Community Hospital Internal Medicine Perspectives: Vol. 14: Iss. 1, Article 10.
DOI: 10.55729/2000-9666.1299. Available at: https://scholarlycommons.gbmc.org/jchimp/vol14/iss1/10
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Greater Baltimore Medical Center
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Journal of Community Hospital Internal Medicine Perspectives, Vol. 14, Iss. 1
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