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Clinical Problem Solving: Radiology
October 2007

Radiology Quiz Case 1—Diagnosis

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Arch Otolaryngol Head Neck Surg. 2007;133(10):1060. doi:10.1001/archotol.133.10.1060

Few cases of what Garré1 first described as sclerosing osteomyelitis have been published in the literature since the first report in 1893. This chronic disease, also known as osteomyelitis with proliferative periostitis,2 is characterized histologically by peripheral osteoblastic activity with new bone formation. Although previous descriptions exist in the orthopedic literature, the first mandibular case was reported by Berger3 in 1948. Histologically, the trabeculae are oriented parallel to each other and the fibrovascular stroma is filled with chronic inflammatory cells.4 This pathologic condition is maintained by a mild but prolonged infection that is known to affect several skeletal sites. Frequently, the mandible is the site of infection secondary to dental caries or extractions, but there have been reports without notable sources of an infectious origin and in the setting of normal dentition.5

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