Abstract

Background: Osteomyelitis is an infection of the bone and presents itself in different forms of symptomatology. The infection may spread either from the blood or the adjoining soft tissue structures. Sometimes, the findings are so subtle that even clinical presentation does not match with the ongoing infectious process. Subperiosteal collection is one such finding that may not be evaluated in plain radiography. This may be misdiagnosed due to their resemblance with similar type of pathology such as Morel–Lavallee lesion. A cross-sectional imaging evaluation is must to find the diagnosis in these types of conditions.
Case Presentation: We present a 14-year-old male with similar type of swelling in the right thigh which appeared after 2 weeks of the blunt injury. Plain radiography was normal. Ultrasound, computed tomography, and magnetic resonance imaging revealed it as a case of acute osteomyelitis with subperiosteal collection. The patient was treated with surgical drainage and broad-spectrum antibiotics.
Conclusion: A cross-sectional imaging played a pivotal role in clinching the diagnosis of femoral osteomyelitis with subperiosteal collection. This also helped in the management and follow-up of the patient.

Key words: osteomyelitis, subperiosteal collection, ultrasound, CT, MRI