title: Garré's sclerosing osteomyelitis: case report.
abstract: The aim of this study was to report on a rare case of Garré's sclerosing osteomyelitis. The patient was a 54-year-old woman with a history of treatment for lupus using corticoids for 20 years, and for osteoporosis using alendronate for five years. She presented edema and developed a limitation of left knee movement one year earlier, with mild effusion and pain on metaphyseal palpation, but without fever. She was in a good general state, without local secretion. Images of her knee showed trabecular osteolysis of the distal metaphysis of the femur and a periosteal reaction in both proximal tibias and both distal femurs, compatible with chronic osteomyelitis of low virulence and slow progression. Magnetic resonance imaging showed T2 hypersignal in the femur and tibia. Curettage was performed on the left distal femur, with release of secretion, but this was negative on culturing. A biopsy showed chronic infection and inflammation, fibrosis, xanthogranulomatous reaction and foci of suppuration. Antibiotic therapy was administered for six months. The etiology was not clarified: bacterial infection was suspected, but culturing was generally negative. The chronic process was maintained by low-virulence infection or even after treatment. The differential diagnoses were fibrous dysplasia, syphilis, pustulosis palmoplantaris, rectocolitis, Crohn's disease, SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) and Paget's disease. The unifocal diseases were osteoid osteoma, Ewing's disease, osteosarcoma and eosinophilic granuloma.
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Universidade Federal de Goiás, Goiânia, GO, Brazil.
authors.forename: Frederico Barra
authors.initials: FB
authors.lastname: de Moraes
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Universidade Federal de Goiás, Goiânia, GO, Brazil.
authors.forename: Tainá Melo Vieira
authors.initials: TM
authors.lastname: Motta
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Universidade Federal de Goiás, Goiânia, GO, Brazil.
authors.forename: Alessandra Assis
authors.initials: AA
authors.lastname: Severin
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Universidade Federal de Goiás, Goiânia, GO, Brazil.
authors.forename: Deniel
authors.initials: D
authors.lastname: de Alencar Faria
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Universidade Federal de Goiás, Goiânia, GO, Brazil.
authors.forename: Fernanda
authors.initials: F
authors.lastname: de Oliveira César
authors.affiliation: Anatomopathology Service, School of Medicine, Universidade Federal de Goiás, Goiânia, GO, Brazil.
authors.forename: Siderlei
authors.initials: S
authors.lastname: de Souza Carneiro
keywords: Osteomyelitis/diagnosis; Osteomyelitis/surgery; Osteomyelitis/therapy