To the Editor Russek et al¹ provide a valuable framework for managing and effectively communicating clinical uncertainty. However, uncertainty can only be allowed to persist once life-threatening and serious conditions are excluded. In the present case there remains a possibility that the patient is experiencing osteomyelitis of the distal tibia, with the unicameral bone cyst actually representing an intraosseous abscess, also known as a Brodie abscess.^2,3 This occurs when the body attempts to control an infection by encapsulating the infective osseous epicenter within inert tissue, such as fibrous connective tissue and, ultimately, sclerotic bone.^2,3 A number of factors point to this diagnosis. First, the symptoms were sufficiently severe to impair ambulation. Blood cultures isolated a pathogen unlikely to be a contaminant. Further bacteremia occurred some time after resolution of the enteric symptoms. This rules out a single enteric source and suggests a secondary septic source, namely, an osteomyelitic nidus. The tibia is the most common location for the Brodie abscess to occur, accounting for almost 50% of cases.² Indeed, Brodie’s original 3 cases all occurred in the tibia.⁴ Epidemiologically, the condition is seen most commonly in young men. Typically, in subacute osteomyelitis, with Brodie abscess formation, the inflammatory indices are not elevated in more than 50% of cases.² Further, more than 80% of patients are afebrile.²