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A 3-year-old boy was found to have a non-tender, bony swelling at the base of his right thumb after presenting to A&E with an unrelated injury. The swelling had been present for 6 months and was increasing in size. An X-ray showed an enlarged right first metacarpal containing lytic and sclerotic areas suggestive of chronic osteomyelitis (figure 1A). A raised red/purple plaque was also noted on the lateral aspect of the left upper arm (figure …
Contributors FJG is the lead consultant for this child. SB wrote the first draft of this article. SB and FJG edited subsequent drafts and have both approved the final version.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.