[Garrés sclerosing osteomyelitis of the humerus: a rare diagnosis]

Garré's sclerosing osteomyelitis is a chronic inflammatory condition of the bone without overt clinical signs of infection, characterized by hyperplastic periostitis and cortical thickening. It typically affects long bones in young patients, with humeral involvement being exceptionally rare. The aim of this report is to present a humeral case and review the relevant literature.

a 12-year-old girl presented with right shoulder pain following a fall. Initial radiographs revealed a metaphyseal lytic lesion with cortical thinning and periosteal reaction. MRI showed cortical thickening and soft tissue edema without abscess formation. The initial biopsy suggested a chondroma, leading to intralesional excision. Histopathological analysis ruled out neoplasia and confirmed acute osteomyelitis. Due to persistent pain and radiographic worsening, bone drilling was performed, revealing chronic inflammation and detection of Kingella kingae DNA. Seven years later, the patient experienced a relapse. Surgical treatment included a cortical window, curettage, and filling with Stimulans. Biopsy confirmed Garré's sclerosing osteomyelitis. Seven months later, the procedure was repeated with bioactive glass. Cultures were negative on both occasions. Intravenous and oral antibiotic therapy was administered, with a favorable clinical outcome.

the diagnosis of Garré's osteomyelitis is challenging due to its nonspecific clinical presentation and negative cultures. Management requires combined surgical and antibiotic treatment, with a risk of recurrence and the need for long-term follow-up.