12. 874
 

 
M   23
 
  ?
 
Right hip  pain,  one  year.
 
X-ray  diagnosis:    Tuberculous  osteitis  is  a  possibility,    chondroblastoma.
 
MRI-diagnosis:  Benign  lesion    at the   right     greater  trochanter,  chondroblastoma.
 
In  an  earlier  biopsy  we    could not  make  a  diagnosis,  but  suggested    chronic  osteomyelitis.
 

 
Received:  multiple   bony  fragments, 1  cm    in  aggregate.

jakob 2012-04-09 18:58	My problem: I cannot see any features of a chondroblastoma. Are the minor inflammatory infiltrates adequate to make a diagnosis of osteomyelitis ? Images 6405, 6407, 6408 show loss of osteocytes; could this be a sequester ? could this be aseptic necrosis in an unusual location ? Thanks !
ammus 2012-04-10 12:30	[comment sent by email on Tue, 10 Apr 2012 15:37:51 +0530] I would favour a diagnosis of Garre's sclerosing osteomyelitis.
baumhoer 2012-04-10 17:32	I absolutely agree that there is no chondroblastoma in the histologic pictures presented here. The histology is more or less non-specific with focal loss of osteocytes indicative of necrotic bone. There also seems to be some bone marrow fibrosis in case the fibrotic areas are really derived from inside the bone (orientation is not easy). Taken together, I also think that chronic osteomyelitis is the primary differential diagnosis.