-
The Dental Register Apr 1854
PubMed: 33694669
DOI: No ID Found -
The Medico-chirurgical Review 1831
PubMed: 29918226
DOI: No ID Found -
Indian Journal of Dermatology Jul 2011Psoriatic onycho-pachydermo-periostitis (POPP) is a rare subset of psoriatic arthritis. It is usually localized to the hands and it is characterized by onychodistrophy,...
Psoriatic onycho-pachydermo-periostitis (POPP) is a rare subset of psoriatic arthritis. It is usually localized to the hands and it is characterized by onychodistrophy, soft tissue thickening above the distal phalanx and periosteal reaction. The resolution is very slow due to the involvement of nails and bone. Low dose methotrexate and anti-tumor necrosis factor-α (anti-TNF-α) agents are the suggested therapies. We report a case of a 53-year-old man affected by palmo-plantar slight psoriatic dermatitis, who presented a rapid onset of POPP. Rx imaging showed enthesitis and a moderate phalanx erosion with articular spaces narrowing and swollen periosteal reaction. A magnetic resonance imaging test of the hands showed an initial stage of synovitis and extensive periostitis of the distal phalangeal tufts. The patient has been treated with oral methotrexate for a month with a rapid clinical improvement and pain reduction. As POPP at first manifests as a painful onycodistrophy, it can easily be confused with bacterial perionyxis. The delay in making the correct diagnosis, and therefore, the delay in giving a proper treatment would mean the progressive articular erosion and the permanent invalidation of the patient's ability to use his hands.
PubMed: 21965851
DOI: 10.4103/0019-5154.84743 -
Rheumatology Advances in Practice 2018Hypertrophic pulmonary osteoarthropathy (HPOA) is a syndrome characterized by the triad of periostitis, digital clubbing and painful arthropathy of the large joints,...
OBJECTIVES
Hypertrophic pulmonary osteoarthropathy (HPOA) is a syndrome characterized by the triad of periostitis, digital clubbing and painful arthropathy of the large joints, especially involving the lower limbs. HPOA without clubbing of the digits is considered an incomplete form of HPOA and has been rarely reported. We are presenting here a case of HPOA without clubbing in a patient with lung cancer.
METHODS
A 52-year-old female active smoker presented with a complaint of multiple joint pains with associated morning stiffness, swelling and weight loss for 3 months. On examination, the patient had tenderness to palpation over the anterior shin, but no obvious clubbing was noted. X-rays of the lower extremities revealed periosteal thickening compatible with HPOA.
RESULTS
A bone scan showed increased uptake along the periosteum and cortex of the long bones. In view of her smoking history and weight loss, a chest X-ray was done that revealed an upper lung mass. A diagnosis of lung carcinoma was made on biopsy.
CONCLUSION
Our case demonstrates that the unusual finding of HPOA in the absence of clubbing is a rare entity and can often be missed. Once diagnosed, a prompt search of other associated conditions should be conducted.
PubMed: 31431958
DOI: 10.1093/rap/rky009 -
Clinical Case Reports Jul 2021Bony pain in patients with a history of myelofibrosis warrants further investigation. Although skeletal involvement in myelofibrosis is more commonly osteosclerosis or...
Bony pain in patients with a history of myelofibrosis warrants further investigation. Although skeletal involvement in myelofibrosis is more commonly osteosclerosis or periostitis, it can also cause osteolytic lesions.
PubMed: 34295475
DOI: 10.1002/ccr3.4276 -
Journal of Applied Physiology... Nov 2003Patients with fragility fractures may have abnormalities in bone structural and material properties such as larger or smaller bone size, fewer and thinner trabeculae,... (Review)
Review
Patients with fragility fractures may have abnormalities in bone structural and material properties such as larger or smaller bone size, fewer and thinner trabeculae, thinned and porous cortices, and tissue mineral content that is either too high or too low. Bone models and remodels throughout life; however, with advancing age, less bone is replaced than was resorbed within each remodeling site. Estrogen deficiency at menopause increases remodeling intensity: a greater proportion of bone is remodeled on its endosteal (inner) surface, and within each of the many sites even more bone is lost as more bone is resorbed while less is replaced, accelerating architectural decay. In men, there is no midlife increase in remodeling. Bone loss within each remodeling site proceeds by reduced bone formation, producing trabecular and cortical thinning. Hypogonadism in 20-30% of elderly men contributes to bone loss. In both sexes, calcium malabsorption and secondary hyperparathyroidism increase remodeling: more bone is removed from an ever-diminishing bone mass. As bone is removed from the endosteal envelope, concurrent bone formation on the periosteal (outer) bone surface during aging partly offsets bone loss and increases bone's cross-sectional area. Periosteal apposition is less in women than in men; therefore, women have more net bone loss because they gain less on the periosteal surface, not because they resorb more on the endosteal surface. More women than men experience fractures because their smaller skeleton incurs greater architectural damage and adapts less by periosteal apposition.
Topics: Adult; Aged; Aging; Humans; Osteoporosis
PubMed: 14555675
DOI: 10.1152/japplphysiol.00564.2003 -
International Journal of Clinical and... 2015Periosteal osteosarcoma (PO) is a rare primary malignant bone tumor and a variant of osteosarcoma. It is a surface lesion without evidence of medullary involvement. The... (Review)
Review
Periosteal osteosarcoma (PO) is a rare primary malignant bone tumor and a variant of osteosarcoma. It is a surface lesion without evidence of medullary involvement. The radiologic appearance of periosteal osteosarcoma is a broad-based surface soft-tissue mass that causes extrinsic erosion of thickened underlying diaphyseal cortex and perpendicular periosteal reaction extending into the soft-tissue component. The tumour presents as non-homogeneous masses of speculated osteoid matrix progressively denser from the periphery to their cortical base. The average age is around 28 and the most common location is the proximal third of the femur; with all the lesions diaphyseal in location. The treatment usually indicated is amputation, but in selected cases, radical segmental resection is appropriate. Long-term disease-free survival is possible after resection of the local recurrence. Limb-salvage therapy seems to offer survival equivalent to amputation, and there does not seem to be a substantial risk of late recurrence, dedifferentiation, or disease progression. The current review also highlights on various rare occurrences of periosteal osteosarcoma including the one of calcaneum, fifth metatarsal, mandible cranium, jaws, clavicle, maxilla, sphenoid bone with extensive periosteal extension, metacarpal in a paediatric age group and bilateral metachronous periosteal osteosarcoma. Recent findings relating to genetic factors governing the pathogenesis of PO is also presented.
PubMed: 25784972
DOI: No ID Found -
Dermatology Online Journal Feb 2001
Topics: Biopsy; Face; Humans; Male; Methotrexate; Middle Aged; Osteoarthropathy, Primary Hypertrophic; Penis; Psoriasis; Scalp; Sulfasalazine; Toes
PubMed: 11328632
DOI: No ID Found -
Hawai'i Journal of Health & Social... Feb 2022Periostitis is characterized by periosteal inflammation surrounding tubular bones. The pathophysiology is now considered to be multifactorial and a spectrum of...
Periostitis is characterized by periosteal inflammation surrounding tubular bones. The pathophysiology is now considered to be multifactorial and a spectrum of disorders, recently being redefined as medial tibial stress syndrome (MTSS). Current treatment modalities include preventative and conservative measures, such as activity modification and footwear alterations. There is a paucity of literature for more invasive treatments, such as steroid injections. In conflict with the currently available limited literature, this study reports a case of recurrent tibial periostitis due to blunt trauma treated with steroid injections resulting in symptom resolution and no adverse events. While this case may suggest a therapeutic role for steroids in the treatment of MTSS from blunt trauma, it also highlights the need for additional studies to elucidate the safety profile and therapeutic efficacy of steroid injections.
Topics: Humans; Medial Tibial Stress Syndrome; Periostitis; Tibia; Wounds, Nonpenetrating
PubMed: 35156055
DOI: No ID Found -
Gut Mar 1981The association of finger clubbing and periostitis has been reported in primary biliary cirrhosis and, more rarely, in other forms of chronic liver disease. The...
The association of finger clubbing and periostitis has been reported in primary biliary cirrhosis and, more rarely, in other forms of chronic liver disease. The prevalence of periostitis and its relationship to finger clubbing is unknown. In this prospective study, we have determined the prevalence of periostitis and finger clubbing in 74 patients with primary biliary cirrhosis and 54 with other forms of chronic liver disease. Clubbing was present in 24% of patients with primary biliary cirrhosis, 29% with HBsAg negative chronic active hepatitis, and 23% in the group of miscellaneous liver diseases. Symmetrical periostitis affecting the tibiae and fibulae occurred in 35% of patients with primary biliary cirrhosis, 29% with chronic, active hepatitis and 40% of patients in the miscellaneous group. The distal radii and ulnae were affected in only eight patients (6%). In primary biliary cirrhosis, the presence of finger clubbing was strongly associated with periostitis (P less than 0.01), but this association was uncommon in other forms of chronic liver disease. In all forms of chronic liver disease periostitis commonly occurs in the absence of finger clubbing. Marked tenderness over the distal leg bones is a reliable sign of underlying periostitis, but this sign is present in only a third of affected patients. This study indicates that periostitis affecting the lower leg bones is common in patients with chronic liver disease, and its presence should be sought whether or not the patient has finger clubbing.
Topics: Adult; Aged; Chronic Disease; Female; Humans; Liver Cirrhosis, Biliary; Liver Diseases; Male; Middle Aged; Osteoarthropathy, Secondary Hypertrophic; Periostitis; Prospective Studies
PubMed: 7227854
DOI: 10.1136/gut.22.3.203