Diffuse Periostitis

Question 1

Primary hypertrophic osteoarthropathy/pachydermoperiostitis

Answer 1

digital clubbing and making up approximately 3 to 5% of all cases of hypertrophic osteoarthropathy, genetic disorder primarily affecting African-American males with insidious onset of enlargement of hands and feet and digital clubbing as well as coarsening of the skin on the face and scalp with increased sweating, progresses for approximately 10 years and then regresses, radiographically diffuse widespread symmetrical periostitis involving diaphyses and metaphyses

Question 2

Secondary hypertrophic osteoarth ropathy

Answer 2

occurs in up to 12% of bronchogenic carcinoma patients, also mesothelioma, emphysema, Hokin’ s disease, cystic fibrosis, pulmonary metastasis; has been associated with congenital cyanotic heart disease and also inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease, clinical triad consisting of digital clubbing, periostitis and synovitis, articular findings may mimic inflammatory arthritis, thoracotomy diminishes S I S within 24 hours

Question 3

acropachy

Answer 3

usually seen after treatment for hyperthyroidism when patients are euthyroid or hypothyroid, findings of exophthalmos digital clubbing, pretibial and periostitis similar to secondary HOA

Question 4

Venous stasis

Answer 4

varicose veins in lower extremity

Question 5

Infantil Corticol Hyperstosis( Caffeys disease)

Answer 5

uncommon disorder of incancy usually middle of first year, abrupt onset with fever hyperirritability and soft tissue swelling especially over mandible, periostitis most commonly involves mandible, clavicles, ribs, periostitis can be extreme with considerable bone enlargement

Question 6

Hypervitaminosis A

Answer 6

Can occur in children/adults. acute overdose, vomiting, headache, drwosiness, irritability, anorexia, itching. X-ray confined to after one year olds with periostitis in tubular bones ulna and metatatarsals, clavicles,fibula

Question 7

Scurvy

Answer 7

periostitis may occur in children

subperiosteal bleeding due to low Vit. C.

Question 8

Battered children

Answer 8

multiple areas of solid periosteal new fractures at different stages’ of healing

Question 9

Acromegaly

Answer 9

excessive growth hormone production can stimulate solid bone formation and periosteal reaction

Question 10

Leukemia

Answer 10

Multiple areas of bone destruction

Question 11

Normal

Answer 11

children under 2 have normal periosteal reaction