Xanthogranulomatous osteomyelitis: multimodality imaging of a rare case involving tibial diaphysis with review of literature

Skeletal Radiol. 2024 Dec 23. doi: 10.1007/s00256-024-04851-9. Online ahead of print.

Abstract

The case report discusses xanthogranulomatous osteomyelitis, a rare inflammatory bone condition that can resemble malignancy on imaging studies. The report details a case of a 42-year-old woman with left leg pain, swelling, and redness lasting 4 months. Imaging revealed a lytic lesion in the left tibia with endosteal erosion, and MRI showed extraosseous soft tissue extension. An open biopsy confirmed xanthogranulomatous osteomyelitis. Following surgical curettage and bone grafting, the patient recovered well at subsequent follow-ups until 1 year after surgery. The article emphasizes the importance of distinguishing xanthogranulomatous osteomyelitis from other malignancies and discusses its epidemiology, clinical presentation, diagnostic techniques, and relevant imaging features, highlighting the potential for misdiagnosis based on overlapping characteristics with conditions like lymphoma and Ewing sarcoma.

Keywords: Enhancing mass; Histiocytic; Lytic bone lesion; Osteomyelitis; Xanthogranulomatous inflammation.