Presentation
Thigh pain.
Patient Data
Within the proximal metadiaphysis of the right femur, located eccentrically within the cortex is a lytic lesion measuring 2.7 cm with a central sclerotic focus. There is a permeative appearance to the lesion with a broad zone of transition as well as aggressive periosteal reaction. No definite soft tissue component is identified.
Anterior femoral osteomyelitis, involucrum 1.8 x 2.8 in coronal, sequestrum centrally, with sinuses to deep aspect of overlying vastus intermedius.
Case Discussion
The patient went onto biopsy and tuberculosis was confirmed as the cause.
A "sequestrum" is a floating piece of bone secondary to necrosis and resorption of surrounding bone. The "involucrum" is the periosteal new bone formation surrounding the sequestrum.
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