A 14-year-old boy treated conservatively for frontal sinusitis returns with a tender, doughy swelling over the forehead with underlying dullness on percussion. Imaging shows erosion of the outer table of the frontal bone with a subperiosteal collection. The MOST likely diagnosis is:

• A Frontal mucocele
• B Subperiosteal haematoma
• C Osteoma of frontal sinus
• D Pott's puffy tumour ✓

Explanation

Pott's puffy tumour is osteomyelitis of the frontal bone with a subperiosteal abscess, a complication of untreated frontal sinusitis classically seen in adolescent males. The diploic veins of the frontal region are valveless, allowing infection to spread from the sinus mucosa into the marrow. A frontal mucocele expands slowly and remoulds rather than erodes acutely, an osteoma is a slow-growing benign bone tumour without preceding infection, and trauma rather than sinusitis precedes a subperiosteal haematoma.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

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Written and medically reviewed by the StethoPrep medical team.