PMC3505913_01
(a) 2 months later, the lytic lesion has rapidly progressed and destroyed the external cortical bone of the proximal peroneal head. (b) Initial right knee radiography where we notice a small bony spicule at the proximal fibula head.
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fig1
Knee radiography showed a lytic lesion with ill-defined margin in the proximal right fibula measuring 1 x 1 cm and breaking through the outer cortex (Figure 1(a)). We reserved the differential diagnosis of focal osteomyelitis versus a tumoral process since the radiography showed that progressive lesion (Figure 1(b)).
Sagittal MRI section of the lower limbs. We notice the presence of a T2 hypersignal at the level of the proximal right fibular head, with erosion of the lateral cortical bone and extension into adjacent soft tissues in the form of a collection.
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fig2
T2 images of the proximal right fibular head with breakage through the outer cortical bone and an abscess extension in the surrounding soft tissues. This excluded the tumoral process as a causal agent and oriented us to a focal osteomyelitis with local infiltration of peripheral tissues (Figure 2).