Fig. 1

Preoperative imaging evaluation determined osteomyelitis lesion range and severity in 2012. The plain radiography of left tibial approximal diaphysis showed a central area of radiolucency with a surrounding thick rim of reactive bone sclerosis (A, B white arrows). CT scan found a cloaca (C, D white arrows) and adjacent reactive bone (E–G, red areas) from lesion area of Panel B (red arrows). Then we performed 3D reconstruction analysis by using a software Amria to determine the reactive bone within the intramedullary (H tibial; I intramedullary reactive bone; J, K sagittal section of tibia). The infection was confirmed by the emission computed tomography (ECT) (L–O)