Needle Arthroscopy for the Surgical Management of Brodie's Abscess in the Distal Tibia of an Infant.

Abstract

Brodie's abscess is a form of subacute osteomyelitis that typically arises in the metaphyseal regions of long bones and is characterised by an insidious onset in the absence of raised inflammatory markers. Standard treatment involves evacuation and curettage of the abscess cavity, often in conjunction with a course of antibiotics. Traditionally, this is done through an open surgical approach under fluoroscopic guidance; however, in the paediatric population, this holds the potential for damage to the growth plate and injury to adjacent neurovascular structures. Needle arthroscopy (NA) is emerging as a minimally invasive alternative to conventional arthroscopy, facilitating access to joints using small "Nano-instruments". We report on the novel application of this technology to assist in treating a transphyseal Brodie's abscess in the left distal tibia of a 16-month-old male. To our knowledge, this is the first reported instance of NA being used to instrument Brodie's abscess.