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Calvarial sclerosing osteomyelitis.

J Klisch1, J Spreer, I Bötefür

  • 1Department of Neuroradiology, University of Freiburg, Germany. Klisch@nz11.ukl.uni-freiburg.de

Pediatric Neurosurgery
|March 29, 2002
PubMed
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Sclerosing osteomyelitis of the calvarium is a rare condition causing painful head swelling. This case highlights its diagnostic imaging features and successful surgical reconstruction.

Area of Science:

  • Medical Imaging
  • Neurosurgery
  • Orthopedic Oncology

Background:

  • Calvarial sclerosing osteomyelitis is a rare but serious condition affecting the skull.
  • It can present with non-specific symptoms such as painful head swelling, mimicking other pathologies.

Observation:

  • A 15-year-old male presented with painful head swelling and skull X-ray findings of irregular radiolucency.
  • Advanced imaging (MRI and CT) revealed a well-demarcated intradiploic lesion with skull thickening from frontal to parietal regions.

Findings:

  • The lesion demonstrated characteristic imaging signals: low T1, heterogeneous post-gadolinium enhancement, and mixed T2 signals.
  • Computer-navigated neurosurgery was performed for lesion resection.
  • The resulting craniotomy defect was successfully reconstructed using a preformed titanium implant.

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Implications:

  • Sclerosing osteomyelitis of the calvarium should be considered in the differential diagnosis of skull osteolytic and sclerosing lesions.
  • Accurate diagnosis and surgical management are crucial for favorable outcomes.
  • This case underscores the utility of advanced imaging in identifying this rare condition.