Garre’s sclerosing osteomyelitis is a form of chronic osteomyelitis which commonly affects children and young adults. Here, we report one such case of Garre’s sclerosing osteomyelitis in a 20‑year‑old female who presented with facial asymmetry and inability to open mouth. On clinical examination, it was bony hard swelling with trismus. History of infected second molar tooth extraction was present. Computed tomography (CT) scan showed thickening and sclerosis of the ramus and condylar process of mandible,
on right side, with proliferative periostitis. Magnetic resonance imaging (MRI) showed soft tissue edema and inflammation, in the form of enlargement of right masseter and pterygoid muscles with intramuscular fluid collection. On the basis of history, clinical signs and imaging features, diagnosis of Garre’s osteomyelitis with fascial space infection was made. To our knowledge, very few
cases of Garre’s osteomyelitis present with superimposed fascial space infection, as it is otherwise a non‑suppurative condition. Fistula formation is a very rare incidence as it is seen in our case.
Keywords: : CT proliferative periostitis; MRI Garre’s osteomyelitis; suppurative osteomyelitis
Introduction
Chronic osteomyelitis with proliferative periostitis (also known as periostitis ossificans or Garré’s sclerosing osteomyelitis) is a distinctive form of chronic osteomyelitis.[1]
It is commonly associated with odontogenic infections in children and young adults.[1,2] The first case was reported in tibia[2] and Berger described this condition to affect mandible for the first time.[1] The common causative pathogens of this condition are staphylococci, klebsiella and streptococci.[2