‘‘Penumbra sign’’ in knee pain: a case of distal femur osteomyelitis

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dc.contributor.authorTosyali H.K.
dc.contributor.authorÇakir A.
dc.date.accessioned2024-07-22T08:01:53Z
dc.date.available2024-07-22T08:01:53Z
dc.date.issued2024
dc.description.abstract‘‘Penumbra sign’’ is a characteristic finding in magnetic resonance imaging (MRI) of Brodie’s abscess, a rare variant of subacute osteomyelitis. We aimed to discuss the imaging finding penumbra sign that will help in the diagnosis of osteomyelitis and may be useful to clinicians in differential diagnosis. A 26-year-old male patient presented to the emergency department with complaints of pain and limping in the right knee that did not go away. He had a history of arthroscopic debridement and percutaneous fixation surgery due to osteochondral fragment 3 years ago. There were no additional findings in the patient’s vital parameters, physical examination, and medical history. X-ray imaging revealed two screws in the distal femur and a well-defined sclerotic rim surrounding a radiolucent lesion anterior to the screws. MRI revealed a lesion in the distal femoral metaphysis with low-density fluid and hyperintense granulation tissue surrounding it. After surgical abscess drainage and local debridement, bone cement was placed in the resulting cavity. Teicoplanin treatment was started. The patient was discharged and complete recovery was achieved in the second month. The diagnosis of osteomyelitis is often missed or confused with bone tumors in non-traumatic cases presenting with persistent bone pain. MRI imaging is frequently used in differential diagnosis, and detection of characteristic imaging signs such as the penumbra sign accelerates the diagnosis. In this context, emergency department clinicians, in particular, should be cautious and not forget that early treatment can be started by recognizing these signs. © 2024, Associacao Brasileira de Divulgacao Cientifica. All rights reserved.
dc.identifier.DOI-ID10.1590/1414-431X2023e12976
dc.identifier.issn0100879X
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/11628
dc.language.isoEnglish
dc.publisherAssociacao Brasileira de Divulgacao Cientifica
dc.rightsAll Open Access; Gold Open Access
dc.subjectAbscess
dc.subjectAdult
dc.subjectFemur
dc.subjectHumans
dc.subjectMale
dc.subjectOsteomyelitis
dc.subjectPain
dc.subjectRadiography
dc.subjectbone cement
dc.subjectC reactive protein
dc.subjectdiclofenac
dc.subjectteicoplanin
dc.subjectabscess drainage
dc.subjectadult
dc.subjectarthroscopic debridement
dc.subjectarthroscopy
dc.subjectArticle
dc.subjectbacterial arthritis
dc.subjectbone pain
dc.subjectcase report
dc.subjectchondrosarcoma
dc.subjectchronic disease
dc.subjectclinical article
dc.subjectcomputer assisted tomography
dc.subjectdifferential diagnosis
dc.subjectdistal femur
dc.subjectemergency ward
dc.subjecteosinophilic granuloma
dc.subjecterythrocyte sedimentation rate
dc.subjectfemur metaphysis
dc.subjectfollow up
dc.subjectfracture fixation
dc.subjectgranulation tissue
dc.subjecthospitalization
dc.subjecthuman
dc.subjectleukocyte count
dc.subjectlimp (gait)
dc.subjectloading drug dose
dc.subjectmale
dc.subjectnuclear magnetic resonance imaging
dc.subjectosteoid osteoma
dc.subjectosteomyelitis
dc.subjectPenumbra sign
dc.subjectperoperative care
dc.subjectsecondary prevention
dc.subjectsubacute osteomyelitis
dc.subjectabscess
dc.subjectdiagnostic imaging
dc.subjectfemur
dc.subjectosteomyelitis
dc.subjectpain
dc.subjectradiography
dc.title‘‘Penumbra sign’’ in knee pain: a case of distal femur osteomyelitis
dc.typeArticle

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