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Osteomyelitis appearing as bone tumor: a case series


Introduction:  Focal bone lesions are common and often found on routine radiology examinations. While many lesions are true neoplasms, several bone abnormalities are not tumors. It is essential for radiologists and clinicians to be aware of this possibility and to identify characteristic features that make it possible to differentiate between bone tumors and lesions that resemble bone tumors. This case series will specifically discuss osteomyelitis, which resembles a bone tumor

Case Description: There were three cases with features of osteomyelitis that appeared as bone tumors. The first case is a 3-year-old girl with swelling in her right knee. The differential diagnosis based on X-ray examination are chondroblastoma and aneurysmal bone cyst. The second case is a 24-year-old man with left knee swelling. The differential diagnosis based on X-ray examination is chondroblastoma and giant cell tumor (GCT). The third case is a 45-year-old man with swelling and pain in his right thigh. The differential diagnosis based on X-ray examination is periosteal osteosarcoma. All three cases underwent laboratory examination and showed signs of infection, such as leucocytosis, elevated ESR, and elevated CRP. Histopathology examination of all cases shows chronic inflammation.

Conclusion: On X-ray examination, it is difficult to differentiate between osteomyelitis and bone tumors. Cases of osteomyelitis that resemble bone tumors emphasize the importance of clinical history, laboratory examination, and radiography because they are generally difficult to detect.



  1. Mhuircheartaigh JN, Lin YC, Wu JS. Bone tumor mimickers: A pictorial essay. Indian J Radiol Imaging. 2014;24(3). doi:10.4103/0971-3026.137026
  2. Kang HJ, Choi HY, Park JS, Park SY, Jin W, Ryu KN. Lesions that Mimic Musculoskeletal Infection: A Pictorial Essay. J Korean Soc Radiol. 2018;78(3). doi:10.3348/jksr.2018.78.3.200
  3. Wang F, Li J, Yu D, Wang Q. Chondroblastoma of the distal femoral metaphysis. Med (United States). 2018;97(17). doi:10.1097/MD.0000000000010336
  4. De Salvo S, Pavone V, Coco S, Dell’agli E, Blatti C, Testa G. Benign Bone Tumors: An Overview of What We Know Today. Vol. 11, Journal of Clinical Medicine. 2022. doi:10.3390/jcm11030699
  5. Restrepo R, Zahrah D, Pelaez L, Temple HT, Murakami JW. Update on aneurysmal bone cyst: pathophysiology, histology, imaging and treatment. Vol. 52, Pediatric Radiology. 2022. doi:10.1007/s00247-022-05396-6
  6. Shi LS, Li YQ, Wu WJ, Zhang ZK, Gao F, Latif M. Imaging appearance of giant cell tumour of the spine above the sacrum. Vol. 88, British Journal of Radiology. 2015. doi:10.1259/bjr.20140566
  7. Ma JL, Wu Y, Wen JX, Zhong ZW, Yu BH, Liu C, et al. Images of giant cell tumor and chondroblastoma around the knee: retrospective analysis of 99 cases. Quant Imaging Med Surg. 2023;13(2). doi:10.21037/qims-22-616
  8. Yang J, Tian W, Zhu X, Wang J. Chondroblastoma in the long bone diaphysis: a report of two cases with literature review. Vol. 31, Chinese journal of cancer. 2012. doi:10.5732/cjc.011.10402
  9. Murphey MD, Nomikos GC, Flemming DJ, Gannon FH, Temple HT, Kransdorf MJ. Imaging of Giant Cell Tumor and Giant Cell Reparative Granuloma of Bone: Radiologic-Pathologic Correlation. Radiographics. 2001;21(5).
  10. Ambrosi F, Righi A, Benini S, Magagnoli G, Chiaramonte I, Manfrini M, et al. Giant cell tumor of bone in patients under 16 years old: A single-institution case series. Cancers (Basel). 2021;13(11). doi:10.3390/cancers13112585
  11. Tepelenis K, Papathanakos G, Kitsouli A, Troupis T, Barbouti A, Vlachos K, et al. Osteochondromas: An updated review of epidemiology, pathogenesis, clinical presentation, radiological features and treatment options. In Vivo (Brooklyn). 2021;35(2). doi:10.21873/INVIVO.12308
  12. Liu XW, Zi Y, Xiang LB, Han TY. Periosteal osteosarcoma: A review of clinical evidence. Vol. 8, International Journal of Clinical and Experimental Medicine. 2015.

How to Cite

Kezia Sondang Mukti, Martadiani, E. D. ., & Dewi, P. U. . (2024). Osteomyelitis appearing as bone tumor: a case series. Indonesia Journal of Biomedical Science, 18(1), 95–98.




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Kezia Sondang Mukti
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Elysanti Dwi Martadiani
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Putu Utami Dewi
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