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. 2021 Jun 24;92(6):753–759. doi: 10.1080/17453674.2021.1941624

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© 2021 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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graphic file with name IORT_A_1941624_F0004a_B.jpg — Case no. 5. A 13-year-old female with osteomyelitis of distal humerus as a late manifestation of cat scratch disease. (A) AP radiography of the elbow with discrete permeative osteodestruction pattern, cortical irregularity, and no periosteal reaction (circle). (B–C) Bone marrow infiltration of the medial epicondyle with permeative destruction of underlying cortex on axial proton density image (arrow, B) and coronal T1-weighted (arrow, C). (D) Bone marrow edema in the area and extraosseous extension with cortex destruction. Abnormal thickening and increased T2-weighted signal intensity within the common flexor origin from the lateral epicondyle due to inflammatory infiltration (white arrow) with edema of the surrounding subcutaneous fat tissue. (E) Corresponding color Doppler sonography shows cortical discontinuity with extraosseous soft tissue extension without significant hypervascularisation of the surrounding structures (yellow star).

graphic file with name IORT_A_1941624_F0004b_C.jpg — Case no. 5. A 13-year-old female with osteomyelitis of distal humerus as a late manifestation of cat scratch disease. (A) AP radiography of the elbow with discrete permeative osteodestruction pattern, cortical irregularity, and no periosteal reaction (circle). (B–C) Bone marrow infiltration of the medial epicondyle with permeative destruction of underlying cortex on axial proton density image (arrow, B) and coronal T1-weighted (arrow, C). (D) Bone marrow edema in the area and extraosseous extension with cortex destruction. Abnormal thickening and increased T2-weighted signal intensity within the common flexor origin from the lateral epicondyle due to inflammatory infiltration (white arrow) with edema of the surrounding subcutaneous fat tissue. (E) Corresponding color Doppler sonography shows cortical discontinuity with extraosseous soft tissue extension without significant hypervascularisation of the surrounding structures (yellow star).