Bibliographic record
Abstract
(See page 1360 for the Photo Quiz.) Diagnosis: Brodie abscess of the tibia due to Aggregatibacter aphrophilus. Right knee plain radiograph. Bilateral leg magnetic resonance image. Aggregatibacter aphrophilus is a facultative anaerobic small gram-negative bacillus formerly known as Haemophilus aphrophilus [1, 2]. This organism is known to colonize the human oral cavity [3] and has been implicated in HACEK (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella) endocarditis and brain abscesses [4, 5]. Bone and joint infections are rare, with more than two-thirds of all such cases involving the axial skeleton. There is a paucity of literature describing A. aphrophilus osteomyelitis in long bones. To our knowledge, this is the first report of a Brodie abscess due to A. aphrophilus involving the tibia. Sir Benjamin Collins Brodie, an English surgeon who pioneered research into bone and joint disease, was the first to describe this phenomenon [6]. The subacute course usually presents with chronic pain over several months to years. If and when the subacute infection converts to frank osteomyelitis, patients classically present with a draining abscess extending from the tibia out through the shin, although involvement of other long bones such as the femur and humerus has been described [7–9]. The most frequent pathogen is Staphylococcus aureus [10]. Brodie abscesses are best visualized by computed tomography and can present as an oval or elliptical radiolucency usually >1 cm surrounded by heavy sclerosis. Plain film radiographs of the right tibia/fibula anteroposterior view (A) and lateral view (B), at the 5-month postdebridement follow-up. Acknowledgments. Written informed consent was obtained from the patient for publication of this case report and accompanying images; we thank the patient for providing the images of his leg and allowing us to describe his clinical course for publication. We also thank Dr Catherine Hui for providing expedient orthopedic care for this patient. Potential conflicts of interest. All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.088 | 0.021 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".