Periosteal reaction
Encyclopedia
A periosteal reaction is the formation of new bone
in response to injury
or other stimuli of the periosteum
surrounding the bone
. It is most often identified on X-ray
films of the bones.
A periosteal reaction can result from a large number of causes, including injury and chronic irritation due to a medical condition such as hypertrophic osteopathy
, bone healing
in response to fracture
, chronic stress injuries
, subperiosteal hematoma
s, osteomyelitis
, and cancer
of the bone. It may also occur as part of thyroid acropachy
, a severe sign of the autoimmune thyroid disorder Grave's disease.
Other causes include Menkes kinky hair syndrome and hypervitaminosis A
.
It can take about three weeks to appear.
appearance can be helpful in determining the cause of a periosteal reaction (for example, if other features of periostitis
are present), but is usually not enough to be definitive. Diagnosis
can be helped by establishing if bone formation is localized to a specific point or generalized to a broad area. The appearance of the adjacent bone will give clues as to which of these is the most likely cause
.
Appearances include solid, laminated, spiculated, and Codman's triangle.
Bone
Bones are rigid organs that constitute part of the endoskeleton of vertebrates. They support, and protect the various organs of the body, produce red and white blood cells and store minerals. Bone tissue is a type of dense connective tissue...
in response to injury
Injury
-By cause:*Traumatic injury, a body wound or shock produced by sudden physical injury, as from violence or accident*Other injuries from external physical causes, such as radiation injury, burn injury or frostbite*Injury from infection...
or other stimuli of the periosteum
Periosteum
Periosteum is a membrane that lines the outer surface of all bones, except at the joints of long bones. Endosteum lines the inner surface of all bones....
surrounding the bone
Bone
Bones are rigid organs that constitute part of the endoskeleton of vertebrates. They support, and protect the various organs of the body, produce red and white blood cells and store minerals. Bone tissue is a type of dense connective tissue...
. It is most often identified on X-ray
X-ray
X-radiation is a form of electromagnetic radiation. X-rays have a wavelength in the range of 0.01 to 10 nanometers, corresponding to frequencies in the range 30 petahertz to 30 exahertz and energies in the range 120 eV to 120 keV. They are shorter in wavelength than UV rays and longer than gamma...
films of the bones.
Etiology
Hypertrophic osteopathy
Hypertrophic osteopathy is a bone disease secondary to cancer in the lungs.-Presentation:It is characterized by new bone formation on the outside of the diaphyses of long bones of the limbs, without destruction of cortical bone. Symptoms include stiffness and warm, firm swelling of the legs, and...
, bone healing
Bone healing
Bone healing, or fracture healing, is a proliferative physiological process in which the body facilitates the repair of a bone fracture....
in response to fracture
Bone fracture
A bone fracture is a medical condition in which there is a break in the continuity of the bone...
, chronic stress injuries
Stress fracture
A stress fracture is one type of incomplete fracture in bones. It is caused by "unusual or repeated stress" and also heavy continuous weight on the ankle or leg...
, subperiosteal hematoma
Hematoma
A hematoma, or haematoma, is a localized collection of blood outside the blood vessels, usually in liquid form within the tissue. This distinguishes it from an ecchymosis, which is the spread of blood under the skin in a thin layer, commonly called a bruise...
s, osteomyelitis
Osteomyelitis
Osteomyelitis simply means an infection of the bone or bone marrow...
, and cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
of the bone. It may also occur as part of thyroid acropachy
Acropachy
Acropachy is a medical condition characterized by subperiosteal new bone formation, . This most commonly manifests as clubbing of the fingers and toes with soft tissue swelling. It is sometimes associated with Graves' disease but not with other causes of hyperthyroidism...
, a severe sign of the autoimmune thyroid disorder Grave's disease.
Other causes include Menkes kinky hair syndrome and hypervitaminosis A
Hypervitaminosis A
Hypervitaminosis A refers to the effects of excessive vitamin A intake.-Presentation:Effects include* Birth defects* Liver problems* Reduced bone mineral density that may result in osteoporosis* Coarse bone growths...
.
It can take about three weeks to appear.
Diagnosis
The morphologicalMorphology (biology)
In biology, morphology is a branch of bioscience dealing with the study of the form and structure of organisms and their specific structural features....
appearance can be helpful in determining the cause of a periosteal reaction (for example, if other features of periostitis
Periostitis
Periostitis, also known as periostalgia, is a medical condition caused by inflammation of the periosteum, a layer of connective tissue that surrounds bone...
are present), but is usually not enough to be definitive. Diagnosis
Diagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...
can be helped by establishing if bone formation is localized to a specific point or generalized to a broad area. The appearance of the adjacent bone will give clues as to which of these is the most likely cause
Etiology
Etiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....
.
Appearances include solid, laminated, spiculated, and Codman's triangle.