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Revista Brasileira de Ortopedia May 2019Florid reactive periostitis is a benign and rare lesion that is a recurrent diagnostic problem. Its etiopathogenesis remains unknown. Florid reactive periostitis...
Florid reactive periostitis is a benign and rare lesion that is a recurrent diagnostic problem. Its etiopathogenesis remains unknown. Florid reactive periostitis consists of a fibrotic, cartilage-producing tumor accompanied by an aggressive inflammatory periosteal and soft tissue reaction. It typically occurs in adolescents and young adults, mostly female; it often affects hand and foot bones, and it may occur in long bones. Its diagnosis remains a major challenge due to the vast possibility of differential diagnoses. Therefore, careful clinical, radiological, and pathological evaluation is required to establish a proper diagnosis. We report the case of a patient with florid reactive periostitis in the proximal phalanx of the right index finger, who underwent surgical excision with a wide margin, from the second ray to the proximal third of the second metacarpal bone, and evolved without complications, with satisfactory range of motion and strength.
PubMed: 31363290
DOI: 10.1055/s-0039-1692430 -
Journal of Dentistry (Shiraz, Iran) Dec 2021Odontogenic infections such as periapical lesions (PLs) can cause changes in the adjacent tissues. Infection of the maxillary posterior teeth can be easily transmitted...
STATEMENT OF THE PROBLEM
Odontogenic infections such as periapical lesions (PLs) can cause changes in the adjacent tissues. Infection of the maxillary posterior teeth can be easily transmitted to the maxillary sinus and cause changes in the maxillary sinus mucosa. Cone-beam computed tomography (CBCT) has high accuracy and sensitivity for detection of odontogenic lesions and is efficient for maxillary sinus assessment.
PURPOSE
This study aimed to assess the maxillary sinuses for abnormalities such as mucosal thickening, polyps, and periostitis, and evaluate the periapical status of maxillary posterior teeth considering the presence of PLs, their size and distance from the sinus floor by evaluating CBCT images.
MATERIALS AND METHOD
This retrospective, cross-sectional study evaluated the CBCT scans of 143 patients, depicting the posterior maxilla with at least one premolar or molar tooth present in this region. Sinus abnormalities (mucosal thickening, sinus polyps, and periostitis) and presence/ absence of PLs, its size, and its distance from the sinus floor were all assessed on CBCT scans. Data were analyzed using the Chi-square test in SPSS version 21 (a= 0.05).
RESULTS
PLs were observed in 31.2% of the cases. In presence of PLs, mucosal thickening was noted in 56.8%, sinus polyps in 29.6% and periostitis in 1.3% of the maxillary sinuses. All teeth with a CBCT periapical index (CBCTPAI) score of 5 were associated with sinus abnormalities; there was neither correlation between the sizes of lesions, nor their distance from the sinus floor with sinus abnormalities (> 0.05).
CONCLUSION
PLs in the posterior maxilla have a direct correlation with the maxillary sinus abnormalities. However, the size or distance of PLs from the sinus floor had no significant effect on the frequency of sinus abnormalities.
PubMed: 34904124
DOI: 10.30476/DENTJODS.2021.87286.1254 -
Indian Journal of Dermatology,... 2012
Topics: Adult; Arthritis, Psoriatic; Humans; Male; Nail Diseases; Periostitis; Toes
PubMed: 22772628
DOI: 10.4103/0378-6323.98088 -
Microsurgery Mar 2022Metacarpal nonunion is a rare condition. The osteogenic capacity of periosteal free flap was investigated in five patients with metacarpal nonunion and impaired bone...
BACKGROUND
Metacarpal nonunion is a rare condition. The osteogenic capacity of periosteal free flap was investigated in five patients with metacarpal nonunion and impaired bone vascularization.
PATIENTS AND METHODS
Surgery was performed between 64 and 499 days after the initial bone osteosynthesis. The average age was 27.6 (range 16-32) years. Nonunion was caused by excessive periosteal removal in two patients, extensive open trauma in three. Four nonunions were diaphyseal, one metaphyseal. A periosteal medial femoral condyle free flap was raised on the descending genicular artery for four patients, the superomedial genicular artery for one. After osteosynthesis with a plate, the flap was wrapped around the metacarpal, overlapping the bone proximally and distally. The recipient vessel were the dorsal branch of the radial artery and a vena comitans in the anatomical snuffbox in four patients, at the base of the first webspace in one.
RESULTS
The flap size ranged from 5 × 3.5 cm to 8 × 4 cm. No postoperative complication occurred. Radiological bone union was achieved 3 to 8 months after surgery. One patient had a full range of motion, one a slight extension lag of the proximal interphalangeal joint, two moderate joint stiffness of the proximal interphalangeal or metacarpophalangeal joint (one requiring plate removal and extensor tenolysis), one severe stiffness that allowed using a hook grip which was the aim of the surgery.
CONCLUSION
In case of metacarpal nonunion with impaired bone vascularization, the periosteal medial femoral condyle free flap provides an effective and biomimetic approach to bone healing.
Topics: Adolescent; Adult; Femur; Fractures, Ununited; Free Tissue Flaps; Humans; Metacarpal Bones; Range of Motion, Articular; Young Adult
PubMed: 34636060
DOI: 10.1002/micr.30826 -
Allergy, Asthma, and Clinical... 2020Epinephrine auto-injectors are expected to deliver the drug intramuscularly.
BACKGROUND
Epinephrine auto-injectors are expected to deliver the drug intramuscularly.
OBJECTIVE
To study whether injection through clothing influences the frequency of subcutaneous and intraosseous/periosteal deposition of epinephrine.
METHODS
Skin to muscle and skin to bone distances were measured for 303 children and adolescents and 99 adults. Distance was determined by ultrasound, with high or low pressure on the ultrasound probe. The risk/percentage of subcutaneous and intraosseous/periosteal injections was calculated using the lower and upper limits for the authority-approved length of EAI needles as provided by two high pressure EAI manufacturers and one low pressure EAI manufacturer. The addition winter clothing on the delivery of epinephrine was illustrated by comparing drug delivery fissue depth with no clothes. Furthermore, the riof non-intramuscular delivery for the shortest and longest approved needle length was calculated.
RESULTS
When using EpipenJr in children < 15 kg the risk of intraosseous/periostal injection was reduced from 1% and 59% for the shortest and longest approved needle length to 0 and 15% with winter clothes. The Auvi-Q 0.1 mg had no risk of intraosseous/periosteal injection. However, the subcutaneous deposition risk increased from 94% and 28% to 100% and 99% with winter clothes. The risk of subcutaneous injection using EpipenJr in the youngest children increased from 13% and 0% to 81% and 1% with winter clothes, and with Epipen in adults from 45% and 17% to 60% and 38%. Emerade, had a risk of subcutaneous injection in adults increasing from 14% and 10% to 28% and 21% adding winter clothes.
CONCLUSION
The risk of intraosseous/periosteal injections decreases and the risk of subcutaneous injection increases when injecting through winter clothes for all EAIs.
PubMed: 32322286
DOI: 10.1186/s13223-020-00422-4 -
Medicine Dec 2023Florid reactive periostitis (FRP), a rare reactive bone lesion, typically presents in the short tubular bones of the extremities, with infrequent occurrences in the long... (Review)
Review
RATIONALE
Florid reactive periostitis (FRP), a rare reactive bone lesion, typically presents in the short tubular bones of the extremities, with infrequent occurrences in the long tubular bones. This report discusses a unique case of FRP in the clavicle, managed through comprehensive lesion debridement and bone grafting, yielding positive results over a 3-year duration.
PATIENT CONCERN
A 25-year-old male presented with a discernible mass at the left sternal end of the clavicle, discovered incidentally 2 weeks prior. The patient exhibited no clinical signs of inflammation, pain, sinus tract, or suppuration.
DIAGNOSIS
Initial pathological examination of the local excision suggested benign lesions, although malignancy could not be ruled out. A definitive diagnosis of clavicular FRP was reached post complete lesion resection, with supporting evidence from postoperative pathology, imaging, and clinical symptoms.
INTERVENTION
The left clavicle was reconstructed through an open surgical procedure involving total mass removal and ipsilateral extraction of an iliac bone of suitable dimensions. This was implanted into the clavicular bone defect and internally fixed with a plate.
OUTCOMES
Three years of consecutive follow-up revealed no recurrence of hyperplasia, absence of mass or tenderness at the left sternal end of the clavicle, and unimpaired function of adjacent joints.
LESSONS
The primary clinical challenge with FRP is its diagnosis. While pathological diagnosis remains crucial, it is also important to incorporate imaging and clinical symptoms for a comprehensive assessment. Complete mass excision may offer specific benefits in distinguishing FRP from its malignant counterparts.
Topics: Male; Humans; Adult; Periostitis; Clavicle; Radiography; Inflammation; Diagnosis, Differential
PubMed: 38115327
DOI: 10.1097/MD.0000000000036674 -
The Dental Register May 1864
PubMed: 33696682
DOI: No ID Found -
The Dental Register Feb 1862
PubMed: 33696291
DOI: No ID Found -
The American Journal of Dental Science Jul 1852
PubMed: 30750990
DOI: No ID Found -
Orthopaedic Surgery Jun 2021To evaluate and analyze the potential relationship between periosteal reaction and medial compartment knee osteoarthritis (KOA), and to assess the independent risk... (Comparative Study)
Comparative Study
OBJECTIVE
To evaluate and analyze the potential relationship between periosteal reaction and medial compartment knee osteoarthritis (KOA), and to assess the independent risk factors for the development of periosteal reaction associated with medial compartment KOA.
METHODS
This is a retrospective comparative study. From January 2019 to December 2019 at the Third Hospital of Hebei Medical University, a total of 363 patients (726 knees) with medial compartment KOA were enrolled in this study according to our inclusion and exclusion criteria, including 91 males and 272 females, with an mean age of 57.9 ± 12.8 years (range, 18-82 years). Among these patients, 206 patients (412 knees) were allocated to the periosteal reaction group (44 males and 162 females) and 157 patients (314 knees) were allocated to the non-periosteal reaction group (47 males and 110 females). The classification of KOA severity was based on Kellgren and Lawrence (K-L) grading system. The malalignment of the lower extremities in coronal plane was evaluated as medial proximal tibial angle (MPTA), hip-knee-ankle angle (HKA), and lateral distal femoral angle (LDFA). Patients demographics and radiographic parameters were recorded in the two groups. Intra-observer and inter-observer reliabilities of all radiological measurements were analyzed by intraclass correlation coefficients (ICCs). Univariate analyses were conducted for comparison of differences with continuous variables between patients with periosteal reaction and without periosteal reaction. Multivariate logistical regression analysis was performed to determine the independent risk factors of radiographic parameters for periosteal reaction.
RESULTS
The overall incidence of periosteal reaction associated with medial compartment KOA was 56.7%. Furthermore, we observed that the incidence of periosteal reaction significantly increased with age and correlated with K-L grade progression (P < 0.05). There was a statistically significant difference between the two groups. In the multivariate logistical regression analysis, HKA and JLCA were identified as independent risk factors of the development of periosteal reaction in patients with medial compartment KOA (odds ratio [OR], 0.594; 95% confidence interval [CI] 0.544-0.648; P < 0.05; OR, 0.851; 95% confidence interval CI 0.737-0.983; P < 0.05; respectively), with other radiographic parameters including MTPA (OR 0.959; 95% CI 0.511-0.648; P > 0.05), LDFA (OR 0.990; 95% CI 0.899-1.089; P > 0.05), and JSW (OR 1.005; 95% CI 0.865-1.167; P > 0.05).
CONCLUSIONS
In this retrospective study, patients with lower HKA and higher JLCA were identified as independent risk factors for the development of periosteal reaction, which occurred most commonly adjacent to the lateral of proximal tibia diaphysis, and thus we concluded that periosteal reaction may be an anatomical adaptation for medial compartment KOA based upon these results.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Osteoarthritis, Knee; Periosteum; Radiography; Retrospective Studies; Tibia; Young Adult
PubMed: 33961333
DOI: 10.1111/os.12963