Presentation
Intermittent left mandibular pain and swelling.
Patient Data
Abnormal expansile appearance of the left mandible with abnormal and asymmetric decreased T1 signal and increased T2 signal. There is thinning of the cortex as well as soft tissue edema adjacent to the lesion.
Bony expansion, cortical thinning, and diffuse sclerosis of the left mandible. This is present through mandibular ramus into the proximal mandibular body. There is marked periosteal reaction as well as cortical breakthrough surrounding the lesion. Edema (less obvious on bone windows) is present within the masseter muscle with adjacent mild fat stranding.
Case Discussion
Sclerosing osteomyelitis of Garre is a rare disease entity predominantly affecting young adults and children. It frequently asymmetrically involves the mandible. It is thought to be associated with low-grade infection and could be related to dental disease such as cavities. This version of chronic osteomyelitis is also known as periostitis ossificans. Treatments include observation, management of pain by NSAIDS, or bone curettage if conservative treatment fails.
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