-
Current Allergy and Asthma Reports Mar 2019Osteitis is recognized as a common factor in recalcitrant chronic rhinosinusitis (CRS). There is evidence for the association of osteitis with revision surgeries and CRS... (Review)
Review
PURPOSE OF REVIEW
Osteitis is recognized as a common factor in recalcitrant chronic rhinosinusitis (CRS). There is evidence for the association of osteitis with revision surgeries and CRS severity, in terms of higher Lund-Mackay scores. This is a narrative review on the osteitis in CRS patients.
RECENT FINDINGS
Evidence to date is inconclusive with regard to the etiology and pathogenesis of this bony thickening. Histopathology of osteitis in primary CRS is likely a process of neo-osteogenesis and bone remodeling. For better understanding, various associating factors have been studied including an inflammatory pattern of rhinosinusitis. Recent studies have associated osteitis with nasal polyps and tissue eosinophilia with the increase in periostin expression and P-glycoprotein mucosal expression. There is no association of osteitis to symptoms or quality of life. Osteitis is an outcome of neo-osteogenesis rather than inflammatory processes in CRS patients without a prior history of surgery. While CT has become a staple in osteitis assessment, the standards for grading osteitic severity remain in an experimental stage. There is no association between the presence or severity of osteitis at the time of surgery and clinical outcomes at 1 year after surgery. This review provides a comprehensive overview of the pathogenesis, epidemiology, and correlation with clinical and biological factors of osteitis in CRS patients.
Topics: Adult; Chronic Disease; Female; Humans; Male; Middle Aged; Osteitis; Rhinitis; Sinusitis
PubMed: 30874957
DOI: 10.1007/s11882-019-0855-5 -
Rheumatology International Jul 2020Osteitis condensans ilii is a noninflammatory condition of an uncertain etiology, characterized by sclerotic bone lesions located mainly in the iliac region of the... (Review)
Review
Osteitis condensans ilii is a noninflammatory condition of an uncertain etiology, characterized by sclerotic bone lesions located mainly in the iliac region of the sacroiliac joints. In many patients, osteitis condensans ilii remains an incidental imaging finding; however, it has been associated with lower back pain and may mimic inflammatory rheumatic conditions such as axial spondyloarthritis. The diagnosis is based on the presence of the characteristic sclerotic lesions on radiographs and the exclusion of other conditions that are associated with back pain. Management is usually conservative with the use of physical therapy and analgesics, and it is associated with a favorable prognosis. Herein, we conducted a narrative literature review using the terms osteitis condensans ilii, and we identified case reports, case series, reviews, and original studies associated with the condition. The aim of this article is to raise the awareness of this underrecognized clinicoradiological condition and to enable the health-care providers to recognize clinical and radiological features that should raise suspicion of the osteitis condensans illi, and to describe the treatment options.
Topics: Decision Trees; Diagnosis, Differential; Humans; Ilium; Low Back Pain; Osteitis; Osteitis Deformans; Physical Therapy Modalities; Radiography; Sacroiliac Joint; Sclerosis; Spondylarthropathies; Tomography, X-Ray Computed
PubMed: 32328707
DOI: 10.1007/s00296-020-04582-9 -
Current Sports Medicine Reports Apr 2003Osteitis pubis is a painful condition, usually caused by abnormal muscle forces acting on the symphysis pubis. The symptoms of osteitis pubis mimic many other injuries... (Review)
Review
Osteitis pubis is a painful condition, usually caused by abnormal muscle forces acting on the symphysis pubis. The symptoms of osteitis pubis mimic many other injuries that affect the athlete's groin. To correctly diagnose this condition, the clinician must maintain a high index of suspicion. Reports suggest this condition is more common in men than women. Confirmatory radiographs, bone scans, and magnetic resonance imaging aid the diagnosis. Once diagnosed, the prognosis for full recovery is good, although lengthy. Typical treatments include physical therapy, involving strengthening the abdominal and hip muscles, and improving range of motion of the hip, particularly the muscles of internal rotation. Corticosteroid injections, wedge resection of the symphysis, curettage, and arthrodesis have all been used with variable success.
Topics: Athletic Injuries; Cumulative Trauma Disorders; Diagnosis, Differential; Female; Humans; Incidence; Male; Osteitis; Prognosis; Pubic Bone; Radiography; Recovery of Function; Sports Medicine
PubMed: 12831666
DOI: 10.1249/00149619-200304000-00009 -
Sports Medicine (Auckland, N.Z.) May 2011Athletic osteitis pubis is a painful and chronic condition affecting the pubic symphysis and/or parasymphyseal bone that develops after athletic activity. Athletes with... (Review)
Review
Athletic osteitis pubis is a painful and chronic condition affecting the pubic symphysis and/or parasymphyseal bone that develops after athletic activity. Athletes with osteitis pubis commonly present with anterior and medial groin pain and, in some cases, may have pain centred directly over the pubic symphysis. Pain may also be felt in the adductor region, lower abdominal muscles, perineal region, inguinal region or scrotum. The pain is usually aggravated by running, cutting, hip adduction and flexion against resistance, and loading of the rectus abdominis. The pain can progress such that athletes are unable to sustain athletic activity at high levels. It is postulated that osteitis pubis is an overuse injury caused by biomechanical overloading of the pubic symphysis and adjacent parasymphyseal bone with subsequent bony stress reaction. The differential diagnosis for osteitis pubis is extensive and includes many other syndromes resulting in groin pain. Imaging, particularly in the form of MRI, may be helpful in making the diagnosis. Treatment is variable, but typically begins with conservative measures and may include injections and/or surgical procedures. Prolotherapy injections of dextrose, anti-inflammatory corticosteroids and a variety of surgical procedures have been reported in the literature with varying efficacies. Future studies of athletic osteitis pubis should attempt to define specific and reliable criteria to make the diagnosis of athletic osteitis pubis, empirically define standards of care and reduce the variability of proposed treatment regimens.
Topics: Athletic Injuries; Cumulative Trauma Disorders; Diagnosis, Differential; Groin; Humans; Magnetic Resonance Imaging; Osteitis; Pain; Pubic Bone; Pubic Symphysis
PubMed: 21510714
DOI: 10.2165/11586820-000000000-00000 -
Otolaryngologic Clinics of North America Feb 2017Our understanding of chronic rhinosinusitis (CRS) show biofilm and osteitis play a role in the disease's pathogenesis and refractory. Studies point to its role in... (Review)
Review
Our understanding of chronic rhinosinusitis (CRS) show biofilm and osteitis play a role in the disease's pathogenesis and refractory. Studies point to its role in pathogenesis and poor prognosis. Outside the research laboratory, biofilm detection remains difficult and specific treatment remains elusive. It is believed that osteitis is a nidus of inflammation and occurs more commonly in patients with refractory CRS. However, osteitis may be exacerbated by surgery and a marker of refractory disease, not a causative agent. Surgery remains the mainstay treatment for biofilm and osteitis with mechanical disruption and removal of disease load providing the most effective treatment.
Topics: Biofilms; Chronic Disease; Disease Management; Humans; Nasal Bone; Osteitis; Prognosis; Rhinitis; Sinusitis
PubMed: 27888915
DOI: 10.1016/j.otc.2016.08.005 -
Current Sports Medicine Reports 2012Osteitis pubis is one of many etiologies of groin pain in athletes. It is a painful overuse injury of the pubic symphysis and the parasymphyseal bone that typically is... (Review)
Review
Osteitis pubis is one of many etiologies of groin pain in athletes. It is a painful overuse injury of the pubic symphysis and the parasymphyseal bone that typically is found in athletes whose sports involve kicking, rapid accelerations, decelerations, and abrupt directional changes. Athletes most commonly present with a complaint of anterior and/or medial groin pain but also can present with lower abdominal, adductor, inguinal, perineal, and/or scrotal pain. Symptoms can be severe and can limit participation in sport until treatment is instituted. Imaging is useful for ruling out other etiologies of groin pain, identifying concomitant pathology, and confirming the diagnosis itself. Treatment is varied but usually includes nonoperative measures of rest, rehabilitation, and/or pharmacotherapy and also may include injections and/or surgical procedures. A high clinical suspicion should exist when evaluating soccer, rugby, or American football players and distance runners who present with complaints of groin pain.
Topics: Adrenal Cortex Hormones; Athletes; Athletic Injuries; Female; Groin; Humans; Male; Osteitis; Pain; Pubic Symphysis; Severity of Illness Index
PubMed: 22410702
DOI: 10.1249/JSR.0b013e318249c32b -
European Archives of... Oct 2016Chronic rhinosinusitis is a common debilitating condition characterized by inflammation of the nose and paranasal sinuses. Osteitis is an associated finding but it is... (Review)
Review
Chronic rhinosinusitis is a common debilitating condition characterized by inflammation of the nose and paranasal sinuses. Osteitis is an associated finding but it is not clear whether it is cause or effect. This review will report on studies that have examined the role of osteitis in CRS, with the ultimate aim of clarifying the definition, pathogenesis and clinical implications of this relatively new clinical entity. Literature searches of Medline, EMBASE and CENTRAL using the search terms osteitis, rhinosinusitis, sinusitis, rhinitis, chronic disease, and recurrence were performed. 21 articles were identified and reviewed. The papers highlighted key pathological features including periosteal thickening, new woven bone formation, bone resorption, fibrosis and inflammatory cell infiltration. Radiological grading systems and basic science research into the role of matrix metalloproteinases and P-glycoprotein were also identified and reviewed.
Topics: ATP Binding Cassette Transporter, Subfamily B, Member 1; Bone Remodeling; Chronic Disease; Humans; Matrix Metalloproteinases; Osteitis; Radiography; Recurrence; Rhinitis; Sinusitis
PubMed: 26525884
DOI: 10.1007/s00405-015-3817-0 -
Obstetrical & Gynecological Survey Apr 1995Osteitis pubis is a painful, noninfectious inflammatory condition that involves the pubic bone, symphysis, and surrounding structures. Initially associated with urologic... (Review)
Review
Osteitis pubis is a painful, noninfectious inflammatory condition that involves the pubic bone, symphysis, and surrounding structures. Initially associated with urologic procedures, osteitis pubis has been described as a complication of various obstetrical and gynecological procedures including vaginal deliveries. An incidence of approximately 2 to 3 percent has been observed after the Marshall-Marchetti-Krantz urethropexy. Although the pathogenesis of osteitis pubis is not clear, periosteal trauma seems to be an important initiating event. Pain is the primary symptom associated typically with difficulty in ambulation and the characteristic "waddling gait." A low grade fever, elevated sedimentation rate, and mild leukocytosis may be observed. Radiographic findings which include reactive sclerosis, rarefaction, and osteolytic changes lag behind the symptoms by about 4 weeks. The major differential diagnosis is osteomyelitis; however, the self-limiting nature and its response to nonantibiotic therapy indicates that osteitis pubis is a separate clinical entity. Treatment is directed at the associated inflammation with most minor cases responding to antiinflammatory agents and bedrest. Other more recalcitrant cases require more involved therapy including systemic steroids and rarely surgical resection. The diagnosis of osteitis pubis should be considered when pelvic pain is present in association with potential trauma to the symphysis pubis. Also, with more women participating in sporting activities patients may present to the physician with osteitis pubis related to athletic injury.
Topics: Diagnosis, Differential; Female; Humans; Osteitis; Pubic Bone; Pubic Symphysis
PubMed: 7783998
DOI: 10.1097/00006254-199504000-00026 -
International Forum of Allergy &... May 2013The role of osteitis, or inflammation involving bone, is 1 potential reason for disease recalcitrance in chronic rhinosinusitis (CRS) and is not extensively studied.... (Review)
Review
BACKGROUND
The role of osteitis, or inflammation involving bone, is 1 potential reason for disease recalcitrance in chronic rhinosinusitis (CRS) and is not extensively studied. This review article will discuss osteitis in CRS, including pathophysiology, diagnostic methods, clinical significance, and treatment modalities.
METHODS
A systematic review of the literature was performed using PubMed search terms osteitis, osteomyelitis, bone involvement, hyperostosis, neo-osteogenesis, osteoneogenesis, remodeling, single positron emission computed tomography (SPECT), and nuclear scintigraphy, with each term cross-referenced with chronic rhinosinusitis. This search was then narrowed to English language articles, which were reviewed for relevance. Cited references of relevant articles were also examined.
RESULTS
The PubMed search identified 231 articles, which after reviewing for inclusion criteria resulted in 26 articles that were included in the current review. Pathophysiology, including current understanding of molecular mechanisms contributing to osteitis, is discussed. Histology, computed tomography (CT), and SPECT have been used to establish a diagnosis. Radiographic staging systems exist but are not standardized. Osteitis has been treated both with intravenous antibiotics and surgery. Five articles involved assessment of outcomes in patients with osteitis.
CONCLUSION
Osteitis involves inflammatory changes in the underlying bone that may lead to recalcitrant CRS. Osteitis is associated with worsened measures of disease severity such as CT, endoscopy, and olfactory scores, and affects the degree of improvement in quality-of-life measures after both medical and surgical treatment. Future studies directed at characterizing the underlying molecular mechanisms including earlier and precise identification may improve our ability to treat this significant aspect of CRS.
Topics: Anti-Bacterial Agents; Chronic Disease; Endoscopy; Humans; Osteitis; Paranasal Sinuses; Quality of Life; Radionuclide Imaging; Rhinitis; Sinusitis; Tomography, X-Ray Computed
PubMed: 23258589
DOI: 10.1002/alr.21118 -
Current Opinion in Otolaryngology &... Feb 2013There is increased recognition of the high prevalence of osteitic changes affecting the bony framework of the sinuses in patients with chronic rhinosinusitis (CRS) with... (Review)
Review
PURPOSE OF REVIEW
There is increased recognition of the high prevalence of osteitic changes affecting the bony framework of the sinuses in patients with chronic rhinosinusitis (CRS) with or without nasal polyps. However, their grading, clinical significance, and management remain controversial.
RECENT FINDINGS
A number of studies have confirmed that there is a clear correlation between radiological severity and extent of CRS, as measured with Lund-Mackay grading system, and osteitis. However, there is little or no correlation between clinical severity and osteitis, with no evidence of worse quality of life or more nasal symptoms or headache in such patients. The number of previous surgeries appears to be closely correlated with the extent of sinusitis, although it is not clear whether that is a direct or a secondary association. Global Osteitis Grading Scale is a novel validated composite grading system - measuring the extent and severity of osteitis.
SUMMARY
Osteitis is more often present in patients with extended radiological disease and in patients undergoing revision surgery. More studies are necessary regarding its management, clinical implications, and natural course.
Topics: Bone Remodeling; Chronic Disease; Diagnostic Imaging; Humans; Inflammation; Osteitis; Paranasal Sinus Diseases; Prognosis; Quality of Life; Severity of Illness Index
PubMed: 23299118
DOI: 10.1097/MOO.0b013e32835ac656