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Bilateral Coronal Synostosis
Joseph Junewick, MD FACR
over 6 years ago
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Osteomyelitis - Rib

Case Detail

Anatomy: Chest
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Infectious-Inflammatory
Created: over 5 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: CT
Activities:
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History

21 month old male with chest pain and swelling; occasional fever.


Case Images


Diagnosis

Staphylococcus aureus osteomyelitis of the rib.

Findings

CT – Mixed attenuation osteocentric soft-tissue swelling of the anterior left chest wall; osteopenia and cortical disruption of the anterior rib.

Discussion

Rib osteomyelitis is most commonly acquired from an adjacent focus of empyema or pneumonia but hematogenous spread can occur. When present, hematogenous spread occurs anteriorly near the costochondral junction (as in this case) or posteriorly near the rib angle. The changes resemble those of typical long bone infection, where there is osseous destruction, reparative bone and soft tissue inflammation. Radiographic differentiation from a healing fracture, neoplasm or Langerhans cell histiocytosis may be difficult.

Reference

Glass RBJ, Norton KI, Mitre SA, et al. Pediatric Ribs: A Spectrum of Abnormalities. Radiographics (2002); 22;87-106.



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