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January 9, 1978

Osteomyelitis Involving Adjacent Ribs

Author Affiliations

From the Department of Thoracic Surgery, Jackson Hospital and Clinic, Montgomery, Ala.

JAMA. 1978;239(2):133. doi:10.1001/jama.1978.03280290053022

EVEN before the advent of antibiotics, osteomyelitis of a rib has been rare. In the following case, the unusual roentgenographic appearance and the involvement of more than one rib created an interesting problem in diagnosis and management.

Report of a Case  A 14-year-old boy was admitted with a draining sinus in the chest wall of six months' duration. At the time of onset a small, tender area appeared just beneath the left nipple. After several days the center of the lesion drained spontaneously. A malodorous discharge persisted despite antibiotic therapy. After obtaining an abnormal chest roentgenogram, his local physician referred him for further examination. The patient denied chest trauma, exposure to tuberculosis, furunculosis, or any other infectious disease in the recent or distant past.On physical examination the patient was afebrile and did not appear ill. There were no abnormal physical findings except for a slightly tender sinus opening just