Question 2691

{"accessible":false,"alternatives":[{"id":13167,"text":"avascular necrosis"},{"id":13168,"text":"Brodie abscess"},{"id":13169,"text":"CRMO (chronic recurrent multifocal osteomyelitis)"},{"id":13170,"text":"osteoid osteoma"},{"id":13171,"text":"slipped upper femoral epiphysis"}],"archived":false,"correctAlternativeId":13168,"explanation":"\u003cp\u003eThe description of focal lucency in a metaphysis should definitely trigger a thought about infection. Don't be put off by the lack of raised inflammatory markers or constitutional symptoms. The description is classic for a Brodie abscess.\u003c/p\u003e\u003cp\u003eAvascular necrosis tends to occur in the femoral epiphysis, and the description is not of a low-grade slipped epiphysis. CRMO is an option, but infection should be the first thing to exclude. \u003c/p\u003e","id":2691,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2691","nextQuestionPath":"/articles/brodie-abscess-1/questions/1944","relatedArticles":[{"id":44830,"title":"Chronic recurrent multifocal osteomyelitis","link":"/articles/chronic-recurrent-multifocal-osteomyelitis?lang=us"}],"alsoUsedIn":[{"id":1485,"kind":"Course","title":"2023 Virtual Conference Private Use - page 1485","link":"https://radiopaedia.org/courses/2023-virtual-conference-private-use/pages/1485"},{"id":1485,"kind":"Course","title":"Paediatric Lectures - page 1485","link":"https://radiopaedia.org/courses/paediatric-lectures/pages/1485"},{"id":1726,"kind":"Course","title":"2023 Virtual Conference Private Use - page 1726","link":"https://radiopaedia.org/courses/2023-virtual-conference-private-use/pages/1726"},{"id":365,"kind":"LiveSchedule","title":"365","link":"https://radiopaedia.org/admin/live_schedules/365"},{"id":280,"kind":"LiveSchedule","title":"280","link":"https://radiopaedia.org/admin/live_schedules/280"}],"stem":"\u003cp\u003eA 9-year-old has an x-ray because of longstanding left-sided hip pain. The x-ray is not normal. There is a well-defined focal lucency in the proximal femoral metaphysis that extends to the physis. No periosteal reaction. \u003c/p\u003e\u003cp\u003eThere are no symptoms apart from pain and blood tests are normal. What's the most likely diagnosis?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/2691"}],"attemptsPercentages":[{"alternativeId":"13168","percentage":27},{"alternativeId":"13170","percentage":38},{"alternativeId":"13167","percentage":13},{"alternativeId":"13171","percentage":9},{"alternativeId":"13169","percentage":13}],"promptToLogin":false,"questionManager":false,"articleId":"brodie-abscess"}