A 14-year-old boy presents with dull pain and mild swelling over the jaw of 4 months duration. There is no fever and no draining sinus. Radiograph shows massive fusiform cortical thickening and dense sclerosis of the mandible with no lytic focus and no sequestrum. Biopsy shows reactive new bone with chronic inflammatory cells. What is the diagnosis?

• A Garre's sclerosing osteomyelitis ✓
• B Brodie's abscess
• C Osteoid osteoma
• D Ewing sarcoma

Explanation

Garre's sclerosing osteomyelitis is a low-grade, nonsuppurative form of chronic osteomyelitis seen in children and adolescents, classically in the mandible. It produces marked lamellar cortical thickening and sclerosis without pus, sequestrum, or a lytic nidus. The absence of any lytic area excludes Brodie's abscess, and the lack of night pain relieved by NSAIDs excludes osteoid osteoma.

Reference: Essential Orthopaedics, Maheshwari, 6th ed.

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