Monofocal Nonbacterial Osteitis of the Distal Radius in Children: A Case Report
Tayeb Ben Tayeb
*
Centre Hospitalier Universitaire Mohammed VI, Tanger, Morocco.
Ayoub Boutahar
Centre Hospitalier Universitaire Mohammed VI, Tanger, Morocco.
Hind Abouel Jaoud
Centre Hospitalier Universitaire Mohammed VI, Tanger, Morocco.
Lamiae Chater
Centre Hospitalier Universitaire Mohammed VI, Tanger, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Chronic bacterial osteitis is a rare inflammatory disease in children that can mimic certain tumor lesions, particularly eosinophilic granuloma. Forms localized to a single site, particularly at the lower end of the radius, are uncommon and make the diagnosis difficult.
Observation: A 7-year-old girl was referred for chronic pain in her right forearm. X-rays showed a metaphyseal cystic lesion of the lower end of the radius, associated with significant thinning of the cortex. Magnetic resonance imaging initially suggested an eosinophilic granuloma due to a well-defined lesion, with hypersignal on water-sensitive sequences and hyposignal on T1-weighted sequences, without collection or soft tissue invasion.
This suspicion of a tumor led to a bone biopsy. The examination revealed a weakened cortex containing a clear, non-hematic fluid. The pathological study revealed non-specific inflammatory osteitis, and microbiological samples were negative, leading to a diagnosis of chronic non-bacterial osteitis.
Treatment with anti-inflammatory drugs led to rapid improvement. Radiology showed gradual filling of the lesion, with complete healing after one year.
Conclusion: This observation illustrates a monofocal form of chronic non-bacterial osteitis mimicking an eosinophilic granuloma on imaging. Biopsy remains essential to rule out a tumor or infectious lesion. The prognosis is favorable with anti-inflammatory treatment.
Keywords: Chronic nonbacterial osteitis, monofocal, child, distal radius, case report