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Current Osteoporosis Reports Apr 2022Periosteal apposition and endosteal remodeling regulate cortical bone expansion and thickness, both critical determinants of bone strength. Yet, the cellular... (Review)
Review
PURPOSE OF REVIEW
Periosteal apposition and endosteal remodeling regulate cortical bone expansion and thickness, both critical determinants of bone strength. Yet, the cellular characteristics and local or paracrine factors that regulate the periosteum and endosteum remain largely elusive. Here we discuss novel insights in cortical bone growth, expansion, and homeostasis, provided by the study of Secreted Frizzled Receptor Protein 4 (Sfrp4), a decoy receptor for Wnt ligands.
RECENT FINDINGS
SFRP4 loss-of function mutations cause Pyle disease, a rare skeletal disorder characterized by cortical bone thinning and increased fragility fractures despite increased trabecular bone density. On the endosteal surface, Sfrp4-mediated repression of non-canonical Wnt signaling regulates endosteal resorption. On the periosteum, Sfrp4 identifies as a critical functional mediator of periosteal stem cell/progenitor expansion and differentiation. Analysis of signaling pathways regulating skeletal stem cells/progenitors provides an opportunity to advance our understanding of the mechanisms involved in cortical bone biology.
Topics: Biology; Cell Differentiation; Cortical Bone; Frizzled Receptors; Humans; Periosteum; Proto-Oncogene Proteins
PubMed: 35182301
DOI: 10.1007/s11914-022-00727-w -
Cureus Jul 2022Runners are most commonly attributed to the shin splint, which is showing commonly the symptom of leg pain. It may be misdiagnosed as compartment syndrome as well. This...
Runners are most commonly attributed to the shin splint, which is showing commonly the symptom of leg pain. It may be misdiagnosed as compartment syndrome as well. This case report depicts the standard condition of medial tibial stress syndrome in a long-distance runner, which is an acute condition with worsening symptoms in many authors' opinion. Patients with accurate symptoms of the conditions may be diagnosed with shin splints for medical usage. Only pain along the posterior medial border of the tibia at the origin of the posterior tibialis muscle should be referred to as shin splints. The chronic form of anterior compartment syndrome may attribute to the runner if they ignore the symptoms of leg pain that occurs in shin splints. Anterior tibial pain during activity is frequent in athletes. It has been linked to various disorders, including periostitis from improper stretching and muscular conditioning, as well as exertional compartment syndromes.
PubMed: 35949752
DOI: 10.7759/cureus.26676 -
Insights Into Imaging Jun 2023Bizarre parosteal osteochondromatous proliferation (BPOP) is a surface-based bone lesion belonging to the group of benign chondrogenic tumors. The aim of this review is... (Review)
Review
Bizarre parosteal osteochondromatous proliferation (BPOP) is a surface-based bone lesion belonging to the group of benign chondrogenic tumors. The aim of this review is to familiarize the readers with imaging features and differential diagnosis of BPOP, also addressing pathological presentation and treatment options. The peak of incidence of BPOP is in the third and fourth decades of life, although it can occur at any age. Hands are the most common location of BPOP (55%), followed by feet (15%) and long bones (25%). On imaging, BPOP appears as a well-marginated mass of heterotopic mineralization arising from the periosteal aspect of the bone. Typical features of BPOP are contiguity with the underlying bone and lack of cortico-medullary continuity, although cortical interruption and medullary involvement have been rarely reported. Histologically, BPOP is a benign bone surface lesion characterized by osteocartilaginous proliferation with disorganized admixture of cartilage with bizarre features, bone and spindle cells. Differential diagnosis includes both benign-such as florid reactive periostitis, osteochondroma, subungual exostosis, periosteal chondroma and myositis ossificans-and malignant lesions-such as periosteal chondrosarcoma and surface-based osteosarcoma. Treatment consists of surgical resection. Local recurrences are common and treated with re-excision.Critical relevance statement Bizarre parosteal osteochondromatous proliferation is a benign mineralized mass arising from the periosteal aspect of bone cortex. Multi-modality imaging characteristics, pathology features and differential diagnosis are here highlighted to familiarize the readers with this entity and offer optimal patient care.
PubMed: 37336832
DOI: 10.1186/s13244-023-01455-0 -
Archives of Pathology & Laboratory... Jan 2022A number of fibro-osseous and osteocartilaginous lesions, especially common in the small bones of the hand and feet, pose a diagnostic challenge and have historically... (Review)
Review
CONTEXT.—
A number of fibro-osseous and osteocartilaginous lesions, especially common in the small bones of the hand and feet, pose a diagnostic challenge and have historically been thought to be reactive lesions. However, modern molecular techniques when supplementing clinical, radiographic, and histologic evaluation suggest they may, in fact, be neoplasms.
OBJECTIVE.—
To review the clinical presentation and histopathologic, molecular, and radiologic features of selective bone lesions, focusing most specifically on subungual exostosis, florid reactive periostitis, and bizarre periosteal osteochondromatous proliferation.
DATA SOURCES.—
Literature review and personal experience are the sources of this review.
CONCLUSIONS.—
Some lesions previously thought to be reactive are locally aggressive and demonstrate reproducible molecular abnormalities, and thus may be neoplasms. Although most common in the bones of the fingers and toes, these lesions also occur in long and other bones. The clinical presentations, radiologic appearances, and histopathologic features often overlap, making the diagnosis challenging, and these lesions may require molecular evaluation to maximize accurate prognostication.
Topics: Bone Neoplasms; Diagnosis, Differential; Exostoses; Hand; Humans; Osteochondroma; Periostitis
PubMed: 33946096
DOI: 10.5858/arpa.2020-0817-RA -
Cell Stem Cell Dec 2019The periosteum is critical for bone maintenance and healing. However, the in vivo identity and specific regulatory mechanisms of adult periosteum-resident skeletal stem...
The periosteum is critical for bone maintenance and healing. However, the in vivo identity and specific regulatory mechanisms of adult periosteum-resident skeletal stem cells are unknown. Here, we report animal models that selectively and durably label postnatal Mx1+αSMA+ periosteal stem cells (P-SSCs) and establish that P-SSCs are a long-term repopulating, functionally distinct SSC subset responsible for lifelong generation of periosteal osteoblasts. P-SSCs rapidly migrate toward an injury site, supply osteoblasts and chondrocytes, and recover new periosteum. Notably, P-SSCs specifically express CCL5 receptors, CCR3 and CCR5. Real-time intravital imaging revealed that the treatment with CCL5 induces P-SSC migration in vivo and bone healing, while CCL5/CCR5 deletion, CCR5 inhibition, or local P-SSC ablation reduces osteoblast number and delays bone healing. Human periosteal cells express CCR5 and undergo CCL5-mediated migration. Thus, the adult periosteum maintains genetically distinct SSC subsets with a CCL5-dependent migratory mechanism required for bone maintenance and injury repair.
Topics: Actins; Adolescent; Adult; Animals; Cell Movement; Child; Female; Flow Cytometry; Fluorescent Antibody Technique; Humans; Immunohistochemistry; Male; Mice, Inbred C57BL; Microarray Analysis; Myxovirus Resistance Proteins; Periosteum; Reverse Transcriptase Polymerase Chain Reaction; Stem Cells; Young Adult
PubMed: 31809737
DOI: 10.1016/j.stem.2019.11.003 -
Foot and Ankle Clinics Sep 2022Plain, weight-bearing radiography is the preferred first-line imaging. Dependent on the suspected pathology, further imaging is indicated. In a soft tissue infection, an... (Review)
Review
Plain, weight-bearing radiography is the preferred first-line imaging. Dependent on the suspected pathology, further imaging is indicated. In a soft tissue infection, an abscess has to be excluded, for example, with ultrasound. Osteomyelitis has a typical triad including osteolysis, periosteal reaction, and bone destruction in radiography, but signs are often delayed. MRI is the gold standard for diagnosis of osteomyelitis with high intensity in T2-weighted and STIR images and intermediate to decreased reticulated hazy intensity in T1-weighted images. In comparison, bone marrow edema is also bright on the T2-weighted image but the T1-weighted image has a confluent low intensity.
Topics: Diabetes Mellitus; Diabetic Foot; Foot Diseases; Humans; Magnetic Resonance Imaging; Osteomyelitis
PubMed: 36096549
DOI: 10.1016/j.fcl.2022.01.002 -
Nature Communications Jul 2022The ontogeny and fate of stem cells have been extensively investigated by lineage-tracing approaches. At distinct anatomical sites, bone tissue harbors multiple types of...
The ontogeny and fate of stem cells have been extensively investigated by lineage-tracing approaches. At distinct anatomical sites, bone tissue harbors multiple types of skeletal stem cells, which may independently supply osteogenic cells in a site-specific manner. Periosteal stem cells (PSCs) and growth plate resting zone stem cells (RZSCs) critically contribute to intramembranous and endochondral bone formation, respectively. However, it remains unclear whether there is functional crosstalk between these two types of skeletal stem cells. Here we show PSCs are not only required for intramembranous bone formation, but also for the growth plate maintenance and prolonged longitudinal bone growth. Mice deficient in PSCs display progressive defects in intramembranous and endochondral bone formation, the latter of which is caused by a deficiency in PSC-derived Indian hedgehog (Ihh). PSC-specific deletion of Ihh impairs the maintenance of the RZSCs, leading to a severe defect in endochondral bone formation in postnatal life. Thus, crosstalk between periosteal and growth plate stem cells is essential for post-developmental skeletal growth.
Topics: Animals; Chondrocytes; Growth Plate; Hedgehog Proteins; Mice; Osteogenesis; Stem Cells
PubMed: 35851381
DOI: 10.1038/s41467-022-31592-x -
European Journal of Radiology Open 2020Periosteum is a fibrous sheath, coating the external bone, except in the articular surfaces, tendon insertions and sesamoid bone surface¹. It changes its aspects and...
Periosteum is a fibrous sheath, coating the external bone, except in the articular surfaces, tendon insertions and sesamoid bone surface¹. It changes its aspects and characteristics with aging, becoming progressively less elastic and more firm. It is composed of two different layers: outer fibrous (firm, collagen-filled) and inner proliferative (cambium, containing osteoprogenitor cells). Four vascular systems are responsible for the blood supply of the periosteum: the intrinsic periosteal system, located between fibrous and proliferative layer; the periosteocortical, the main nutritional arteries of the periosteum; the musculoperiosteal, responsible for the callus formation after fractures; the fascioperiosteal, specifically for each bone.³ It is crucial to bone formation and resorption, reacting to insults in the cortical bone, such as tumors, infections, traumas, medications and arthritic diseases. The aggressiveness of the reaction can be suggested by its radiological aspect and appearance. The periosteum in children is looser compared to adults, resulting in earlier and more exuberant reactions. All these aspects will be detailed, so the essential information all radiologists need to know will be discussed.
PubMed: 32923528
DOI: 10.1016/j.ejro.2020.100249 -
World Journal of Transplantation Sep 2021Voriconazole use has been associated with osteoarticular pain and periostitis, likely due to high fluoride content in the drug formulation. This phenomenon has been... (Review)
Review
Voriconazole use has been associated with osteoarticular pain and periostitis, likely due to high fluoride content in the drug formulation. This phenomenon has been described primarily with high dosage or prolonged course of voriconazole therapy in immunocompromised and transplant patient populations. Patients typically present with diffuse bony pains associated with elevated serum alkaline phosphatase and plasma fluoride levels in conjunction with radiographic findings suggestive of periostitis. We provide a comprehensive review of the literature to highlight salient characteristics commonly associated with voriconazole-induced periostitis.
PubMed: 34631468
DOI: 10.5500/wjt.v11.i9.356