International Journal of Clinical & Medical Images

Case Presentation: A 49 years old male presented with low grade fever and purulent discharge from the right thigh for 2 months duration with minimal clinical response to multiple courses of antibiotics. He revealed a past history of traumatic fracture of the right femur which was corrected by internal fixation 20 years back. His basic clinical and biochemical profiles were normal except a high ESR value of 80 mm/hr. His plain radiograph of right femur showed a thick sheath of periosteal new bone surrounding a sequestrum compatible with an involucrum (Figure 1) as the consequent complication of chronic osteomyelitis. Involucrum and new bone formation is a rare pathological entity and an educational value encountered in day to day clinical practice of this era.