Excellent Functionality Despite Clinico-Radiological Deformity in Osteomyelitis Variolosa - A Case Report

Area of Science:

• Orthopedics
• Infectious Disease Sequelae
• Skeletal Radiology

Background:

• Smallpox eradication in 1980 did not eliminate its long-term osteo-articular complications.
• Osteomyelitis variolosa sequelae present diagnostic challenges, particularly for surgeons unfamiliar with these post-infectious bone abnormalities.

Purpose of the Study:

• To present a case of osteomyelitis variolosa in an elderly patient.
• To illustrate the potential for significant radiological findings with preserved functional independence.

Main Methods:

• Case report of a 70-year-old patient with a history suggestive of smallpox sequelae.
• Clinical examination focusing on elbow joint function and stability.
• Radiological assessment including X-rays to evaluate bone and joint morphology.

Main Results:

• The patient presented with bilateral elbow joint dislocation and multidirectional instability.
• Radiological findings included distorted articular surfaces, proximal radio-ulnar joint ankylosis, ulnar hypoplasia, and metacarpal abnormalities.
• Despite severe radiographic abnormalities, the patient experienced minimal functional disability and maintained independence.

Conclusions:

• Osteomyelitis variolosa can lead to severe, long-lasting osteo-articular deformities.
• Functional outcomes may be surprisingly good despite extensive radiological changes.
• Awareness of these rare sequelae is crucial for accurate diagnosis and management.