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Pediatric Hip Pain with Bone Lesion, Sepsis, and Occam's Razor = Brodie's Abscess Case Report
Barbara Minkowitz1, Eytan Mendelow1, Jennifer Ristic1
1Department of Orthopedics, Morristown Medical Center, 261 James Street, Suite 3C, Morristown, New Jersey.
Introduction:
Brodie's abscess is one type of subacute osteomyelitis that can be difficult to diagnose because characteristic signs and symptoms can be subtle and non-specific. Up to 90% of Brodie's abscess cases are initially misdiagnosed, with a mean delay of 3 months to the correct diagnosis, with 50% of them misdiagnosed as tumors. Other conditions can also present quite similarly.
Case Report:
A 7-year-old male presented with complaints of hip pain and inability to bear weight. X-rays revealed Brodie's abscess in the proximal femur which was initially misdiagnosed as toxic synovitis with an incidental unicameral bone cyst (UBC).
Conclusion:
Brodie's abscess can be a diagnosis that is easily missed and should be included in the differential diagnosis when a child presents with a limp, inability to bear weight, or when a cortical lucency is seen on X-ray. There are no other cases in the literature of Brodie's abscess presenting like toxic synovitis. This case is relevant to pediatricians and orthopedists, particularly pediatric orthopedists.
