According to static data, a disease such as Brody's abscess is relatively rare in modern medical practice. Nevertheless, such cases are still recorded from time to time, so it’s worth knowing what the disease is. So what are the symptoms associated with the disease and who is at risk?
What is a pathology?
Brody abscess is a form of hematogenous osteomyelitis. This disease is characterized by the presence of a sharply limited area of bone damage. Against the background of the disease, there is an accumulation of pus in the human bone tissue, which is the result of previous necrosis.
It should immediately be said that the disease is much more often diagnosed in males aged 14 to 24 years. Brody abscess in children of primary or preschool age is also possible, but such cases are recorded extremely rarely.
The disease, as a rule, affects long tubular bones, namely their meta-epiphyseal division. The occurrence of an abscess in the diaphysis is rare. According to statistics, the most common diagnosis in patients is a Brody abscess of the tibia. Sometimes suppuration is observed in the distal epiphysis of the radial bones. But in other parts of the supporting apparatus, the inflammatory process and suppuration are observed only in individual cases.
The main reasons for the development of an abscess
Brody's abscess is a disease of bacterial origin. In most cases, the cause of the inflammatory process is a staphylococcal infection, although often the presence of other microorganisms, including E. coli, is also determined in the purulent masses. In most cases, the formation of an abscess is the result of osteomyelitis.
Pathogenic bacteria can penetrate bone tissue in different ways. For example, microorganisms often enter the tissues with blood flow from another focus of inflammation, therefore, the presence of purulent infectious ailments in the patient can be attributed to risk factors. Bacteria can also penetrate into the pineal gland from the cavity of the cyst or boil. On the other hand, pathogenic microorganisms are often introduced from the external environment with damage to the skin, the introduction of drugs intravenously or subcutaneously (if hygiene standards were not observed). Sometimes an abscess develops in the postoperative period. By the way, almost always the development of infection is in one way or another associated with a weakening of the immune defense.
Pathogenesis of the disease
Abscess Brody has very pronounced features. Against the background of the necrotic process, a closed cavity of an oval or spherical shape forms in the bone tissues, and its walls are rather stable and smooth. It is inside this cavity that thick purulent masses accumulate. In rare cases, a viscous transparent liquid can be found inside the abscess. By the way, the diameter of the cavity, as a rule, is 2–5 cm.
If we are talking about an old formation, then the wall of the cavity is often lined with fibrous tissues. A concentric zone of bone sclerosis forms around the abscess, and periosteal growths appear in the periosteum.
Symptoms and signs of the disease: what to look for?
Abscess Brody - a chronic disease. Often it develops over the years and even decades without causing any serious symptoms (at least the symptoms are so weak that the patient simply does not pay attention to them).
The disease proceeds sluggishly, and periods of relative well-being give way to a short-term exacerbation, which is accompanied by more pronounced symptoms. For example, patients often report fever and general weakness. Tissues around the affected area of the bone swell, the skin turns red. When pressed, a person feels pain, and the skin feels hot to the touch.
The clinical picture during the “calm” period is blurry. Patients note some discomfort only with increased physical exertion. As the abscess grows, the capsule can be felt to the touch. Often there is a decrease in limb mobility, as well as a change in tissue sensitivity.
Abscess Brody: X-ray and other diagnostic methods
Of course, in this case, the correct diagnosis is extremely important, since the treatment regimen and the success of therapy depend on this. After familiarization with the symptoms that patients complain of, as well as palpations of the affected area, the doctor prescribes an additional study.
One of the most informative tests is radiography. In the picture, the doctor can see the presence of a hollow formation in the tissue of the affected bone. The dimensions of the abscess are small, and its walls are even.
Of course, there are other studies that help diagnose a disease such as Brody's abscess. MRI (magnetic resonance imaging), for example, provides more accurate information and also demonstrates that the neoplasm cavity is filled with purulent masses.
Differential diagnosis and its features
Differential diagnosis in this case is simply necessary, since the symptoms of this disease slightly resemble the clinical picture with tuberculous osteitis. Bone formation can be an eosinophilic granuloma or osteoid osteoma, so additional research is simply necessary.
For example, with tuberculous lesions of the bones, there is no clear lesion - this is a hallmark. Cysts, unlike an abscess, have a cellular structure. Sometimes, to make an accurate diagnosis, Wasserman reacts to syphilis, because this disease is accompanied by the formation of so-called gum in the patient’s bones.
Abscess Brody: treatment
Of course, the disease is much easier to cure in the initial stages - for patients, as a rule, rather conservative therapy. First you need to limit the mobility of the limb with a plaster cast - in this condition, the patient should spend about 4 weeks. During this time, antibiotics are administered intramuscularly, which only the doctor selects, guided by the sensitivity of specific pathogenic microorganisms.
If there is an exacerbation of the inflammatory process, patients are also prescribed anti-inflammatory drugs. In more severe cases, curettage of the abscess cavity is indicated with further treatment with antiseptic agents and the introduction of penicillin (or another antibiotic) directly into the bone formation.
Physiotherapy is also an essential element - UHF treatment is considered the most effective. Naturally, a sick person needs to observe peace, limit physical activity, eat right, do everything in order to activate the immune system.
Surgery is indicated in cases where treatment with medication does not give the expected results. During the procedure, the doctor removes the Brody abscess. Sometimes it is necessary to remove part of the bone tissue - in such cases they are replaced with an implant. With the right approach, this disease is treated without serious complications.