Periostosis

Abstract: This chapter provides the background to why studying infections is important in paleopathology. Moving through the body's responses to infectious agents and the biology of infection, it then focuses on inflammatory changes of different parts of bones for which infection may be a cause. It discusses the nature of periostosis and periostitis, osteitis, osteomyelitis and septic arthritis. It is emphasized that nonspecific responses to a range of etiologies can lead to the same bone change, which may include infection, and if infection is the etiology the response may be the result of any one of many infectious organisms. Location of inflammation related lesions on the skeleton may give better clues to specific etiologies (e.g., ribs and sinuses).

Abstract: Recurrent multifocal periostosis of childhood is an infrequent disease. All cases reported to date have been sporadic. A familial form affecting three siblings is reported herein. Clinical and biologic features were similar to those described in the previously reported cases. This case is of particular interest for two reasons: 1) the pattern of familial clustering suggests autosomal recessive transmission; 2) repeated CT scans were performed in these patients (but not in previously reported cases) and demonstrated early involvement of the three bone layers, suggesting panostosis rather than periostosis.

Abstract: This review discusses our experience with conventional radiography and advanced imaging techniques in the evaluation of diverse soft tissue, skeletal and joint abnormalities frequently observed in patients with both the primary and secondary forms of hypertrophic osteoarthropathy. The manifestations include finger clubbing, elephant feet, cutis verticis gyrata, synovial effusion, periostosis, tuftal hypertrophy and acro-osteolysis. Its coexistence with other skeletal and joint diseases and its imaging differential diagnosis are also reviewed.

Abstract: Twin girls presented with infantile cortical periostosis (Caffey's disease) at 2 and 3 weeks of age, respectively. This disorder initially involved their upper and lower limbs and resulted in fever, irritability and tenderness. X-rays showed extensive periosteal new bone formation. Multiple relapses occurred in the first year of life and during some of these relapses mandibular and clavicular involvement was noted. Prednisolone, 1 mg/kg per day, was used to treat relapses until 9 months of age. Indomethacin therapy at this age at a dose of 3 mg/kg per day allowed the cessation of prednisolone therapy and disease flares were thereafter infrequent and responsive to indomethacin.