| CASE REPORT |
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| Year : 2017 | Volume
: 16
| Issue : 2 | Page : 160-162 |
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Acute hematogenous osteomyelitis presenting as a “Cold” rib in a child
Michael J Annen, Mickaila J Johnston, Joe P Gormley, Eugene Silverman
Department of Radiology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134, USA
Correspondence Address:
Michael J Annen
Department of Radiology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134
USA
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DOI: 10.4103/1450-1147.203067 PMID: 28553185 
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A “cold” defect or an area of decreased radiotracer deposition is the less common appearance of acute hematogenous osteomyelitis (AHO) on a Tc99 m-methylene disphosphonate (Tc99 m-MDP) bone scan. Group A beta-hemolytic Streptococcus (GABHS) is a significantly less common cause of AHO than Staphylococcus aureus, particularly when the infection involves the pelvis or flat bones such as the ribs. Here, we present a case report of isolated acute “cold” hematogenous osteomyelitis in a rib of a child with GABHS bacteremia that was detected on 99Tc-MDP bone scan, with magnetic resonance imaging correlation, and pathologic confirmation after rib resection.
Disclaimer: The views expressed herein are those of the author(s) and do not necessarily reflect the official policy or position of the Department of Navy, Department of Defense, or the U.S. Government.
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