Atypical Osteomyelitis of the Knee. A Case Report.

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The diagnosis of chronic osteomyelitis expanded out of bone is important in order to avoid confusion with a neoplasm. We report an unusual case of chronic osteomyelitis of the femur. A 27-year-old man complaining of motion pain in his right knee, especially in the medial femoral condyle, came to our hospital. He had occasional episodes of pain in the knee after Japanese fencing activities since 1989. Examination of the knee was unremarkable except for slight tenderness and swelling over the vastus medialis. Radiographs showed a clearly defined hemispherical defect with a sclerotic margin in the superior part of the medial femoral condyle of the right knee. MRI and angiograms revealed a tumor-like lesion beyond this sclerotic area which was more suggestive of chronic inflammation. Surgical removal of the lesion showed a granulomatous tissues. Histological examination of scleroitic lesion showed a chronic inflammatory pattern suggesting a diagnosis of primary chronic osteomyelitis originated from subperiosteal bone of the femur.
西日本整形・災害外科学会の論文

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