title: Juvenile mandibular chronic osteomyelitis: multimodality imaging findings.
abstract: OBJECTIVE
  Juvenile mandibular chronic osteomyelitis is a rare entity that predominantly affects children and adolescents, but little is known about the factors that contribute to the recurrent course and eventual resolution of this disease. Here, we describe new findings of soft tissue and mandibular nerve canal involvement.
  
  
  METHODS
  Four patients with mandibular diffuse sclerosing osteomyelitis are presented; all were followed with CT, a few also with MRI and bone scan. We recorded imaging findings of lesion location, pattern of bone formation, presence and evolution of lytic lesions, mandibular nerve, and soft tissue involvement.
  
  
  RESULTS
  In all patients we found enlargement of the mandibular nerve canal and soft tissue changes on CT and MRI (when available). All patients had ground glass bone patterns in conjunction with lamellated/onion skin new periosteal bone formation on CT, and all patients with follow-up CT had change in lytic lesion locations.
  
  
  CONCLUSIONS
  Mandibular nerve canal enlargement, soft tissue abnormalities, and change in location of lytic lesions may represent a diagnostic pattern in mandibular diffuse sclerosing osteomyelitis (Garré) that was not previously entirely recognized as such.
authors.affiliation: Department of Radiology and Diagnostic Imaging, Children's National Medical Center, Washington, DC 20010, USA. nkadom@cnmc.org
authors.forename: Nadja
authors.initials: N
authors.lastname: Kadom
authors.forename: Alexia
authors.initials: A
authors.lastname: Egloff
authors.forename: George
authors.initials: G
authors.lastname: Obeid
authors.forename: Anjum
authors.initials: A
authors.lastname: Bandarkar
authors.forename: Gilbert
authors.initials: G
authors.lastname: Vezina
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003952:Diagnostic Imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement; D008198:Lymph Nodes / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008334:Mandible / Q000473:pathology; D008336:Mandibular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008340:Mandibular Nerve / Q000473:pathology; D008406:Masseter Muscle / Q000473:pathology; D010012:Osteogenesis / Q000502:physiology; D010014:Osteolysis / Q000175:diagnosis; D010019:Osteomyelitis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D010521:Periosteum / Q000473:pathology; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012008:Recurrence; D012598:Sclerosis; D013669:Technetium Tc 99m Medronate; D036542:Tomography, Spiral Computed; D051598:Whole Body Imaging
chemical_list: D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate