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Case 42 

Case 42
Chapter:
Case 42
Author(s):

Joel David

, Anne Miller

, Anushka Soni

, and Lyn Williamson

DOI:
10.1093/med/9780199587506.003.0042
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date: 25 August 2019

A 10-year-old boy presented to his GP with a 4-week history of anterior chest wall pain exacerbated by deep inspiration that was severe enough to prevent him attending school. On examination he was systemically well, but had tenderness over the sternum and right second rib, which appeared prominent. A CXR showed a lytic lesion of the right second rib (Fig. 42.1). He was referred to the orthopaedic team. Given the uncertain nature of the lesion it was thought prudent to commence treatment for osteomyelitis with intravenous antibiotics. Blood cultures taken prior to treatment were subsequently found to be negative.

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