Juvenile mandibular chronic osteomyelitis: multimodality imaging findings

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Mar;111(3):e38-43. doi: 10.1016/j.tripleo.2010.10.027.

Abstract

Background and purpose: Juvenile mandibular chronic osteomyelitis is a rare entity that predominantly affects children and adolescents, but little is known about the factors that contribute to the recurrent course and eventual resolution of this disease. Here, we describe new findings of soft tissue and mandibular nerve canal involvement.

Materials and methods: Four patients with mandibular diffuse sclerosing osteomyelitis are presented; all were followed with CT, a few also with MRI and bone scan. We recorded imaging findings of lesion location, pattern of bone formation, presence and evolution of lytic lesions, mandibular nerve, and soft tissue involvement.

Results: In all patients we found enlargement of the mandibular nerve canal and soft tissue changes on CT and MRI (when available). All patients had ground glass bone patterns in conjunction with lamellated/onion skin new periosteal bone formation on CT, and all patients with follow-up CT had change in lytic lesion locations.

Conclusion: Mandibular nerve canal enlargement, soft tissue abnormalities, and change in location of lytic lesions may represent a diagnostic pattern in mandibular diffuse sclerosing osteomyelitis (Garré) that was not previously entirely recognized as such.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Chronic Disease
  • Diagnostic Imaging*
  • Female
  • Follow-Up Studies
  • Humans
  • Image Enhancement
  • Lymph Nodes / pathology
  • Magnetic Resonance Imaging
  • Male
  • Mandible / pathology
  • Mandibular Diseases / diagnosis*
  • Mandibular Diseases / diagnostic imaging
  • Mandibular Nerve / pathology
  • Masseter Muscle / pathology
  • Osteogenesis / physiology
  • Osteolysis / diagnosis
  • Osteomyelitis / diagnosis*
  • Osteomyelitis / diagnostic imaging
  • Periosteum / pathology
  • Radionuclide Imaging
  • Radiopharmaceuticals
  • Recurrence
  • Sclerosis
  • Technetium Tc 99m Medronate
  • Tomography, Spiral Computed
  • Whole Body Imaging

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Medronate