Pathohistological features and correlations between morphological indices of damage in the form of hematogenous osteomyelitis – Brodie abscess

Authors

  • V. V. Hryhorovskyi Research Institute of Traumatology and Orthopaedics of NAMS of Ukraine,
  • M. P. Hrytsai Research Institute of Traumatology and Orthopaedics of NAMS of Ukraine,
  • A. S. Hordii Research Institute of Traumatology and Orthopaedics of NAMS of Ukraine,
  • O. B. Liutko Research Institute of Traumatology and Orthopaedics of NAMS of Ukraine,
  • А. V. Hryhorovska Research Institute of Traumatology and Orthopaedics of NAMS of Ukraine,

DOI:

https://doi.org/10.14739/2310-1237.2017.1.97322

Keywords:

hematogenous osteomyelitis, Brodie’s abscess, pathohistological features, morphological indices, nonparametric statistics

Abstract

Research objective: On the basis of pathohistological research of the destructive form of hematogenous osteomyelitis with a latent course foci (Brodie’s abscess) and performing of the grade-frequency analysis of the semi-quantitative indices reflecting features of the foci structure to find correlations between some morphological indices of a tissue condition in the damage foci.

As research material fragments of the damaged tissues of the pathological foci of 25 patients with Brodie abscess (from 6 patients tissue material was received twice) served. By the localization of the foci distribution was the following: tibia – 24 cases, femur – 4, calcaneus – 2, clavicle –1. In total 31 histologic and semi-quantitative histomorphometric researches were performed, on the basis of morphological indices the grade-frequency and correlation analysis with association coefficient determination were carried out.

Results. Brodie abscess – a variant of the destructive form of hematogenous osteomyelitis, has certain clinical and clinico-laboratory features, and the lesion foci – characteristic pathological changes. Particularly, average parameters of such clinico-laboratory indices as specific leukocytes number and a portion of stab leukocytes in the formula did not fall outside the limits of normal values. In most cases of Brodie abscess Staphylococcus aureus was seeded from tissues.

The main pathomorphological changes at Brodie abscess involve capsule structures, necrotic and resorptive changes of spongiosa trabecules, features of productive-infiltrative and exudative inflammations in a focus capsule. The cases at which the internal membrane corresponds to a granulation tissue structure, exudative inflammation more often was of low activity, productive inflammation, on the contrary – more often was of high activity; in most cases within tissues small sequesters occur.

Conclusions. Between some morphological indices of Brodie abscess foci tissue condition high significant (p<0.01) correlations which correspond to values of association coefficient in the range of values rа = 0.4-0.6 were found:

  • "granulation tissue prevalence in the capsule " – "productive inflammation of high activity prevalence" – positive dependence, weak association;
  • "granulation tissue prevalence in the capsule " – "presence of small sequesters" – positive dependence, weak association;
  • "productive inflammation of high activity prevalence" – "presence of small sequesters" – dependence positive, moderate association.

References

Dartnell, J., Ramachandran, M., & Katchburian, M. (2012). Haematogenuous acute and subacute paediatric osteomyelitis. A systematic review of the literature. J. Bone and Joint Surg, 94-B(5), 584–595. doi: 10.1302/0301-620X.94B5.28523.

Grigorovskij, V. V. (2013). Aspekty patomorfologii i nomenklatury v sovremennoj klassifikacii nespecificheskikh osteomielitov [Aspects of pathomorphology and nomenclature in the modern classification of nonspecific osteomyelitis]. Ortopedija, travmatologija i protezirovanie, 3(592), 77–87. [in Russian].

Hammad, A., Leute, P. J., Hoffmann, I., Hoppe, S., Lakemeier, S., & Klinger, H.-M. (2015). Acute leg pain with suspected beginning leg compartment syndrome and deep vein thrombosis as differential diagnoses in an unusual presentation of Brodie's abscess: a case report. J. Med. Case Rep., 9, 292. doi: 10.1186/s13256-015-0770-x.

Shah, T. T., Chin, K. F., Noorani, A., & Nairn, D. (2012). Subacute physeal abscess: case report to illustrate treatment with a minimally invasive incision and drainage technique. Ann. R. Coll. Surg. Engl., 94, e51-e54. doi: 10.1308/003588412X13171221502022.

Damir, D., Toader, E., & Creţu, A. (2011). Correlational aspects of hematogenous osteomyelitis in children and adults. Rev. Med. Chir. Soc. Med. Nat. Iasi, 115(1), 269–276.

Buldu, H., Bilen, F.E., Eralp, L., & Kacaoglu, M. (2012). Bilateral Brodie’s Abscess at the proximal Tibia. Singapore Med. J., 53(8), e159-e160.

Yazdi, H., Shirazi, M. R., & Eghbali, F. (2012). An Unusual Presentation of Subacute Osteomyelitis: a Talus Brodie Abscess with Tendon Involvement. Amer. J. Orthopedics., 41(3), E36-E38.

Amanullah, F., Ansari, S., & Kaleem, A. (2013). Brodie's abscess mimicking as of malignancy: case report with radiological features. J. Musculoskelet. Research, 16(01). doi: http://dx.doi.org/ 10.1142/S0218957713720019.

Rajakulendran, K., Picardo, N. E., El-Daly, I., & Hussein, R. (2016). Brodie’s abscess following percutaneous fixation of distal radius fracture in a child. Strat. Traum. Limb. Recon., 11(1), 69–73. doi: 10.1007/s11751-016-0249-3.

Hryhorovskyi, V. V., Hrytsai, M. P., Hordii, A. S., & Hryhorovska, A. V. (2015). Osoblyvosti kliniko-morfolohichnoi kartyny ta diahnostyky «atypovykh form» hematohennoho osteomiielitu dovhykh kistok [Features of clinical and morphological picture and diagnostics of «atypical forms» of hematogenous osteomyelitis of long bones]. Ortopediya, travmatologiya i protezirovanie, 1, 5–11. doi: http://dx.doi.org/10.15674/0030-5987201515-11. [in Ukrainian].

Agarwal, S., Akhtar, M. N., & Bareh, J. (2012). Brodie's abscess of the cuboid in a pediatric male. J. Foot Ankle Surg., 51(2), 258–261. doi: 10.1053/j.jfas.2011.10.040.

Balaji, G., Thimmaiah, S., & Menon, J. (2014) Brodie's abscess of the posterior ilium: a rare cause for low back pain in children. BMJ Case Reports, 2014, bcr2014204684. doi: 10.1136/bcr-2014-204684.

Downloads

How to Cite

1.
Hryhorovskyi VV, Hrytsai MP, Hordii AS, Liutko OB, Hryhorovska АV. Pathohistological features and correlations between morphological indices of damage in the form of hematogenous osteomyelitis – Brodie abscess. Pathologia [Internet]. 2017Apr.7 [cited 2024Dec.24];(1). Available from: http://pat.zsmu.edu.ua/article/view/97322

Issue

No. 1 (2017)

Section

Original research

License

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Лицензия Creative Commons
    1. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

  1. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).