Calvarial sclerosing osteomyelitis

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.

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.