April 11, 20231

Causes of periosteal reaction & new bone formation

Presented by Dr Laith fadhelMBchB, P.G.C.R

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Causes of periosteal reaction Box 36.1 David Sutton text book of radiology

Box 36.1 Causes of periosteal new bone formation

1. Physiologic I n neonates, especially in prematurity2. Congenital Tuberous sclerosis3. Dysplastic Melorheostosis, Engelmann's disease4. Traumatic Local subperiosteal trauma; fracture, including march fracture.

Unrecognized skeletal trauma (Caffey's 'battered baby syndrome')5. Infective Acute: osteomyelitis-staphylococcal, streptococcal, pneumococcal, etc. Chronic: Brodie's abscess, tuberculosis, syphilis (congenital and

acquired), yaws; also from nearby infection, e.g. varicose ulcer; ribs in pulmonary and pleural infections

6. Hypo-and hypervitaminosis Rickets, scurvy, hypervitaminosis A7. Endocrine Thyroid acropachy, hyperparathyroidism healing phase; secondary

hyperparathyroidism in renal osteodystrophy8. Vascular Haemophilia and other bleeding disorders. Myeloid metaplasia probably due

to associated thrombocytopenia. Erythroblastic anaemias. Leukaemias. Varicose veins (before ulceration occurs).Hypertrophic pulmonary osteoarthropathy (probably of vascular aetiology) and pachydermoperiostosis

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Box 36.1 Causes of periosteal new bone formation

9. Collagen disease Polyarteritis nodosa10. Reticuloses Hodgkin's disease , etc11. Neoplastic Primary : benign – meningioma , angioma , osteoid osteoma

malignant – osteiogenic sarcoma , fibro sarcoma , Ewing sarcoma , etc secondary : any metastatic bony deposit me be associated with periosteal reaction

12. Primary joint Ankylosing spondylitis , juvenile chronic arthritis (stills disease ) reitrs syndrome , Rheumatoid arthritis ,osteoarthritis ( femoral

neck only ) 13. Miscellaneous infantile cortical hyperostosis ( Caffey ), histiocytosis

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1 .Physiologic In neonates / especially in premature

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2 .Congenital Tuberous sclerosis

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3 .Dysplastic Melorheostosis

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4.Traumatic March fracture

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5 .Infective Acute osteomyelitis / staph

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6 .Hypo vitaminosis Rickets

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7 .Hyper vitaminosis A

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8 .Endocrine Thyroid acropachy

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9 .Vascular Hemophilia

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10 .Collagen diseases Rheumatoid arthritis

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11 .Reticuloses Hodgkin's diseases / lymphoma

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12 .Neoplastic Benign / osteoid osteoma

Malignant / Ewing's sarcoma

Metastatic / neuroblastoma

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13.Primary joint lesion Ankylosing spondylitis

OA / femoral neck only

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14 .Miscellaneous

Infantile cortical hyperostosis – Caffey