Gorter Jelle, Rykov Kyrill, Ott Pieter, van Raay Jos J A M
Department of Orthopaedic Surgery, Martini Ziekenhuis, Groningen, The Netherlands.
Department of Radiology, Martini Ziekenhuis, Groningen, The Netherlands.
BMJ Case Rep. 2017 Jan 30;2017:bcr2016217772. doi: 10.1136/bcr-2016-217772.
A 17-year-old male patient presented with a swelling on his right shoulder 1 week after a fall. MRI revealed a superficial fluid collection of the acromion and trapezius muscle, with slight enhancement of the wall. The swelling burst open spontaneously after failed conservative therapy and was treated with surgical drainage and antibiotics. Tissue cultures showed a Staphylococcus aureus 1 year later, he presented with local red discolouration and a recurrent painful swelling that fluctuated at palpation. Radiographs showed a lytic lesion of the acromion process. MRI showed a sinus in the lytic cavity and a penumbra sign, which helped to identify this extremely rare occurrence of Brodie's abscess in the acromion process that was breaking through to the subcutaneous fat. The abscess was treated successfully with surgical drainage and intravenous antibiotics. In retrospect, the first MRI showed a small cortical indentation, with slight oedema of the acromion process.
一名17岁男性患者在跌倒后1周出现右肩部肿胀。磁共振成像（MRI）显示肩峰和斜方肌浅表有液体积聚，壁轻度强化。保守治疗失败后，肿胀自行破溃，接受了手术引流和抗生素治疗。组织培养显示为金黄色葡萄球菌。1年后，他出现局部皮肤发红和反复疼痛性肿胀，触诊时有波动感。X线片显示肩峰骨质溶解病变。MRI显示溶解腔内有窦道及半影征，这有助于识别肩峰骨质中极为罕见的布罗迪脓肿破溃至皮下脂肪的情况。该脓肿通过手术引流和静脉用抗生素成功治愈。回顾来看，首次MRI显示有小的皮质凹陷，肩峰骨质有轻度水肿。
