button sequestrum
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The clothes
maketh the sign. Lateral projection of the skull in a 63-year-old diabetic patient with fever and occipital scalp pain demonstrates a lucent lesion with a central opacity resembling a button (inset). The infectious organism destroys the bone, which is replaced by purulent material and granulation tissue, producing a lucency. Central opacity represents an island of dead bone (“button sequestrum”)
A button sequestrum is a small sequestrum of devascularised bone surrounded by lucency. Although classically described in osteomyelitis and eosinophilic granuloma it is also occasionally seen in fibrosarcoma and lymphoma.
Differential diagnoses
- osteoid osteoma
- tuberculous osteomyelitis
- radiation necrosis
- skeletal metastasis
- fibrous dysplasia
- epidermoid and dermoid cyst
- hemangioma
Siehe auch:
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skeletale
Manifestationen der Langerhanszell-Histiozytose