[Brodie's abscess, a pathology difficult to diagnose].

Area of Science:

• Pediatric Infectious Diseases
• Orthopedic Surgery
• Diagnostic Imaging

Background:

• Acute osteoarticular infections in children are rare but require prompt diagnosis and treatment to prevent complications.
• Brodie's abscess (BA) is an uncommon, subacute form of osteomyelitis that poses diagnostic challenges.

Observation:

• A 14-year-old presented with persistent thigh pain, normal initial X-rays, and unremarkable inflammatory markers.
• Ultrasound revealed cortical irregularity, and MRI indicated a lesion in the femoral diaphysis, raising concerns for tumor or infection.
• Staphylococcus aureus was identified via bone biopsy, confirming a multi-sensitive infection.

Findings:

• Despite non-specific clinical and laboratory findings, Brodie's abscess was diagnosed in a pediatric patient.
• The case highlights the importance of advanced imaging and biopsy in diagnosing subacute osteomyelitis.
• Successful management involved surgical debridement and intravenous antibiotics.

Implications:

• Non-specialist physicians should consider Brodie's abscess in the differential diagnosis for persistent bone pain with imaging abnormalities, even with normal inflammatory markers.
• Bone biopsy is essential for differentiating infectious processes from bone tumors.
• Early suspicion and diagnosis of Brodie's abscess can prevent long-term sequelae in pediatric patients.