Right Clavicle Osteomyelitis and Subperiosteal Abscess

8-year-old female with history of right shoulder pain, limited range of motion, fever and leukocytosis. On physical examination, there is palpable fullness within the right supraclavicular region. There is a large region of T1 isointense signal to skeletal muscle within the supraclavicular fossa and base of the neck on the right. There is replacement of the normal marrow fat signal with a large confluent region of STIR hyperintense signal in the clavicle medullary space and surrounding soft tissues. There is a drainable fluid collection at the posteroinferior aspect of the right clavicle with peripheral enhancement on the post contrast images. Findings are compatible with clavicular osteomyelitis with a subpereosteal abscess. The most common site of infection in pediatric patients is at the ends of long bones where there is increased blood flow and altered flow dynamics. Staph aureus is the most common agent of infection.