Brodie abscess overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Abdulkerim Yassin, M.B.B.S[2]
Synonyms and keywords: Subacute Osteomyelitis
Overview
Brodie abscess is a rare subacute or acute chronic osteomyelitis with a pus-filled cavity, vascularized wall and hard sclerotic surrounding bone. It mostly involves the metaphysis of bones (especially tibia) but it can occur at any location and in a patients of any age. It classically presents with pain with out any other systemic symptoms. Thus making an accurate and timely diagnosis is usually difficult. It is usually mistaken with bone tumor. It has insidious onset and the inflammatory markers are unremarkable.
Historical Perspectives
Brodie abscess is first described by a British surgeon sir Benjamin Brodie. Wiles reported Brodie abscesses as a specific form of osteomyelitis in 1951.
Classification
Brodie abscess was first classified radiologically by Kirkaldy-Willis from East-Africa. The currently utilized classification system was initially proposed by Gledhill in 1973 and then modified by Roberts et al in 1982.
- Type IA: Metaphyseal radiolucency without surrounding sclerosis.
- Type IB: Metaphyseal radiolucency with surrounding reactive bone.
- Type II: Metaphyseal radiolucency with cortical erosion.
- Type III: Cortical diaphyseal radiolucency with periosteal reaction.
- Type IV: Diaphyseal lesion with sub periosteal new bone formation.
- Type V: Epiphyseal radiolucency that may appear similar to a chondroblastoma.
- Type VI: Vertebral lesion that may mimic eosinophilic granuloma or tuberculous spondylitis.