Question:hard
A patient has a history of road traffic accident 2 years back, and at the same site has developed pain and swelling. X-ray shows the following features. What will be the diagnosis?
A patient has a history of road traffic accident 2 years back, and at the same site has developed pain and swelling. X-ray shows the following features. What will be the diagnosis?
Show Hint
Old trauma site, slow pain/swelling, onion-skin sclerotic periosteal new bone - a chronic infection.
Updated On: Jun 23, 2026
- Osteogenic sarcoma
- Ewing's sarcoma
- Chronic osteomyelitis
- Multiple myeloma
Show Solution
The Correct Option is C
Solution and Explanation
Step 1: Read the timeline. An injury 2 years earlier and only now pain plus swelling at that exact spot suggests something slow and reactive, not a rapidly growing malignancy.
Step 2: Match that to the radiograph. Layers of dense new cortical bone laid down around the shaft - the onion-skin sclerosis - are typical of Garre sclerosing osteomyelitis, a chronic non-suppurative osteomyelitis driven by low-grade infection that triggers subperiosteal bone formation.
Step 3: Note the clinical mildness. The disease is often nearly asymptomatic, which is why the patient tolerated it for two years before mild symptoms appeared - fully in keeping with a chronic infective process.
Step 4: Knock out the tumours. Osteosarcoma would show sunburst spicules and a Codman triangle, Ewing's would be aggressive in a child, and myeloma would give multiple punched-out lytic holes in an older patient. None carries the post-traumatic, benign, densely sclerotic onion-skin look.\[\boxed{\text{Chronic osteomyelitis}}\]
Step 2: Match that to the radiograph. Layers of dense new cortical bone laid down around the shaft - the onion-skin sclerosis - are typical of Garre sclerosing osteomyelitis, a chronic non-suppurative osteomyelitis driven by low-grade infection that triggers subperiosteal bone formation.
Step 3: Note the clinical mildness. The disease is often nearly asymptomatic, which is why the patient tolerated it for two years before mild symptoms appeared - fully in keeping with a chronic infective process.
Step 4: Knock out the tumours. Osteosarcoma would show sunburst spicules and a Codman triangle, Ewing's would be aggressive in a child, and myeloma would give multiple punched-out lytic holes in an older patient. None carries the post-traumatic, benign, densely sclerotic onion-skin look.\[\boxed{\text{Chronic osteomyelitis}}\]
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