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Insights into Imaging
Fig. 4 | Insights into Imaging

Fig. 4

From: Imaging in non-bacterial osteomyelitis in children and adolescents: diagnosis, differential diagnosis and follow-up—an educational review based on a literature survey and own clinical experiences

Fig. 4

A 14-year-old boy with pain in the left groin and feet. MRI showed an extended focus in the left os ileum/acetabulum with marked paraosseous soft tissue involvement. After bone biopsy of the left os ileum with negative cultures and no evidence of malignancy, therapy was initiated with naproxen, steroids and methotrexate. Three months after the initial MRI, the boy had increasing pain. A follow-up study showed progressive soft tissue swelling with destruction of the left acetabulum/os ileum. After repeat bone biopsy further methotrexate plus pamidronate treatment. A second follow-up MRI showed decreased soft tissue swelling with slightly persisting signal abnormality within the bones

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