Abstract

Emphysematous osteomyelitis is a rare and potentially life-threatening form of osteomyelitis characterized by intraosseous gas. In the absence of prior surgery or open fracture, it is most commonly seen in immunocompromised adults and associated with gram-negative organisms. We report a rare case of acetabular emphysematous osteomyelitis in a 12-year-old immunocompetent male child. Marrow signal alteration with soft tissue collection involving the right acetabular area of pelvic bones was seen on contrast enhanced magnetic resonance imaging. Computed tomography (CT) demonstrated intraosseous air foci with the characteristic pumice stone sign, confirming the diagnosis. Culture grew methicillin-sensitive Staphylococcus aureus. The patient was successfully managed with surgical debridement and antibiotic therapy. Early CT based diagnosis and prompt management are crucial for improving outcomes in this rare condition.

Key words: Emphysematous, osteomyelitis, pumice stone sign, MRI