In chronic haematogenous osteomyelitis, a Brodie's abscess is characterised by which radiological and pathological feature?
- A Thick periosteal reaction surrounding a radiolucent intramedullary cavity with a sclerotic rim, without sequestrum ✓
- B A sequestrum surrounded by dense involucrum with a cloacum
- C Periosteal elevation ('sunburst') with Codman's triangle
- D Medullary expansion with ground-glass matrix
Correct answer: A. Thick periosteal reaction surrounding a radiolucent intramedullary cavity with a sclerotic rim, without sequestrum
Explanation
A Brodie's abscess is a subacute intraosseous abscess, most common in the proximal tibial metaphysis of adolescents, caused by low-virulence organisms (classically Staphylococcus aureus). Radiologically it appears as a well-defined intramedullary radiolucent cavity with a dense sclerotic reactive rim, without a sequestrum — differentiating it from classic chronic osteomyelitis. Sunburst appearance and Codman's triangle suggest osteosarcoma. The involucrum-sequestrum-cloacum triad is seen in classic chronic osteomyelitis from haematogenous or post-traumatic infection.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
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