The most likely pathology associated with the following radiograph is:

Garre’s osteomyelitis The condition occurs almost exclusively in young people and has a predilection for the mandible. The condition presents purely as a periosteal reaction to low-grade infection. Radiological signs There may be a grossly carious tooth present or evidence of pericoronitis. Radiological change is usually restricted to the laying down of periosteal new bone either as an “onion skin” reaction or as a more extensive thickening of the whole body of the mandible. Key Concept