PMC7371598_01
Appearance of right forearm.. Right forearm is swollen, but there is no erythema or flare. A biopsy scar is observable in the middle of the external ventral portion of the forearm.
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Upon physical examination, the circumference of the right forearm was 15 mm larger than that of the left one, but there was no erythema or flare (Fig. 1).
Plain radiograph.. A plain radiograph shows hypertrophic cortical bone and a radiolucent lesion in the diaphysis of the right radius.
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A plain radiograph indicated cortical bone hypertrophy and a well-defined radiolucent lesion in the diaphysis of the right radius (Fig. 2).
Plain CT.. A CT scan shows a longitudinal translucent lesion, a cortical defect of the middle diaphysis, and cortical bone in the bone marrow of the radius. The solid and dotted lines in figure (a) correspond to figure (c) and figure (d), respectively.
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A CT scan showed a 10 cm longitudinal translucent lesion, a cortical defect on the volar side of the middle diaphysis, and cortical bone in the bone marrow of the radius (Fig. 3).
MRI.. (a), (b) An MRI shows that the lesion is hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging inside the radius.. (c), (d) Extraosseous abscess is well visualized as a hypointense lesion on hyperintense lesion on T2WI outside the radius.
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MRI demonstrated that the lesion was hypointense on T1-weighted imaging (T1WI) and hyperintense on T2-weighted imaging (T2WI) inside the bone marrow of the radius (Fig. 4).
Intraoperative findings.. (a) An extraosseous abscess exists beside the pronator teres (*).. (b) A cortical bone defect at the back of the abscess is found (arrow). The abscess, enclosed by a capsule, contained yellowish-brown soft tissue.. (c) There is a bony sequestrum in the diaphysis of the radius (arrow head).. (d) Debridement was performed in the canal of the radius, and good bleeding from the bone was also found.
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An extraosseous abscess was found beside the pronator teres (Fig. 5a), and there was a 5 mm cortical bone defect at the back of the abscess (Fig. 5b). A bony sequestrum was found in the enlarged diaphysis of the radius (Fig. 5c). Debridement was undertaken in the canal of the radius (Fig. 5d).
Image findings one year after surgery.. (a), (b) Plain radiograph and CT scan show the disappearance of the sclerotic lesion and the recovery of the trabecular structure of the radius.. (c) An MRI shows that the extraosseous abscess has disappeared.
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Plain radiograph and CT scan showed the disappearance of the sclerotic lesion and the recovery of the trabecular structure of the radius (Fig. 6a, b). Moreover, an MRI indicated that the extraosseous abscess had disappeared (Fig. 6b).