A 12-year-old girl presents with a 2-month history of dull pain and a firm swelling at the angle of the mandible. She is afebrile. X-ray shows dense cortical thickening and sclerosis of the mandible with laminated subperiosteal new bone, but no lytic focus, no sequestrum, and no sinus tract. Biopsy shows only reactive woven bone with scanty chronic inflammatory cells and no pus. What is the most likely diagnosis?

• A Brodie's abscess
• B Sclerosing osteomyelitis of Garre ✓
• C Ewing sarcoma
• D Monostotic fibrous dysplasia

Explanation

Garre's sclerosing osteomyelitis is a low-grade, non-suppurative form of chronic osteomyelitis seen in children and young adults, classically in the mandible. It produces intense subperiosteal reactive new bone formation and cortical sclerosis without abscess formation, sequestration, or sinus discharge. The absence of a central lytic cavity excludes Brodie's abscess, which characteristically shows a well-circumscribed radiolucency surrounded by a rim of sclerosis. Fibrous dysplasia gives ground-glass expansion rather than layered subperiosteal reaction.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.