69 Brodie’s Abscess (Subacute Osteomyelitis)


Brodie’s Abscess (Subacute Osteomyelitis)

Sam Y. Chun, Ali Islam, Alison Spouge, Anthony G. Ryan, and Peter L. Munk

Clinical Presentation

A 15-year-old boy with knee pain diagnosed with osteochondritis dissecans (OCD) of the knee was sent for MRI evaluation of the OCD.


Figure 69A


Figure 69B


Figure 69C


Figure 69D

Radiologic Findings

An anteroposterior radiograph of the knee (Fig. 69A) shows an area of OCD in the midmedial femoral condyle (arrowheads). A large geographic lytic area in the posteromedial distal femoral metaphysis is also evident (arrows), with marginal sclerosis fading peripherally. A coronal T1 spin-echo image (Fig. 69B) shows a corresponding area of extensive low signal intensity with a small track (arrows) extending caudally to the physeal plate.

A sagittal computed tomography reformat (Fig. 69C) shows the lower end of the low density lesion (arrow) to be in continuity with the physis, which is open posteriorly (arrowheads). Axial inversion recovery (Fig. 69D) shows the lesion to have a heterogeneous appearance (arrowheads) with areas of central intermediate and high signal intensity, surrounded by a low signal intensity rim with surrounding bone marrow and soft-tissue edema.


Brodie’s abscess.

Differential Diagnosis

  • Nonossifying fibroma
  • Osteoblastoma/osteoid osteoma (if < 1.5 cm)
  • Fibrous dysplasia
  • Eosinophilic granuloma



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Feb 14, 2016 | Posted by in MUSCULOSKELETAL IMAGING | Comments Off on 69 Brodie’s Abscess (Subacute Osteomyelitis)

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