Fig. 36.

Cystic tuberculous (TB) osteomyelitis in a 7-year-old boy who had been limping since a minor fall 3 months previously. a An anteroposterior pelvic radiograph shows a well-defined eccentrically located cystic lesion of the lateral right femoral neck with cortical irregularity of the adjacent metaphysis. The femoral head is osteopaenic. b-d Coronal magnetic resonance images. T2 with fat suppression (b) and T1 (c) confirm involvement of the metaphysis and epiphysis and that the process crosses the joint to involve the superolateral acetabulum with a small associated effusion. There is heterogeneous enhancement of the bone and diffuse synovial enhancement post-contrast (d). Bone biopsy–confirmed tuberculosis