Radiographic signs: Periosteal rxn Flashcards Preview

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Flashcards in Radiographic signs: Periosteal rxn Deck (32)
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1

Pathological lifting of the periosteum away from bone due to stimulation.

PEriosteal rxn

2

Stimulants of periosteal rxn

Extension of blood, pus or tumor

Hyperemia

Inflammation

Edema

3

Which layer of periosteum is involved in periosteum rxn

Inner cambium

4

T/F: We don't see the periosteum in normal or abnormal conditions. However we see the bone produced.

True

5

3 types of periosteal rxn pattern

Solid

Laminated

Spiculated

6

PEriosteal rxn:

Single layer of bone layed longitudinally parallel to cortex

Appears smooth, wavy or chunking

Slow growing/Benign

Local or diffuse (tubular bones)

Responds to insult or irritation

Solid

7

Causes of solid periosteal rxn

Local:
Infection
Benign bone neplasm
Eosinophillic granuloma
Fracture healing

Diffuse:
Hypertrophic Osteoarthropathy

Variscosities (lower extremities

8

Example of Local benign bone neoplasm that is a very localized solid periosteal rxn.

Very dense area of cortical thickening

Very common classic bone forming bone tumor

Osteoid osteoma-bone tumor from osteoblast

9

Causes of solid periosteal rxn:

Local

Stimulated by chronic inflammation

Produced by granulation tissue

Cause of compression fx in spine

Eosinophillic granuloma

10

Causes of solid periosteal rxn:

Diffuse excess of bone and joint growth

Hypertrophic Osteoarthropathy

11

Causes of periosteal rxn:

Venous stasis of blood leading to bone pain that causes periostitis in the tibia, fibula and metatarsals

Variscosities

12

CAuses of periosteal rxn:

Callous formation helps produce new collar of new bone

Fracture healing

13

Direct stimulus from an underlying bone lesion (intrinsic); mc fracture
healing, infection, and benign bone neoplasm

Localized periosteal rxn

14

Systemic diseases and the periosteum is reacting; mc hypertrophic
osteoarthropathy

Wide spread periosteal rxn

15

If more than 1 tubular bone shows a periosteal reaction, is it local or diffuse?

Diffuse

16

Cause of Diffuse SOLID Perioteal rxn:

Clinical syndrome consisting digital clubbing

Skin thickening and
Periosteum

3-5% of cases

Radiographically diffuse widespread symmetrical periostitis involving DIAPHYSIS AND METAPHYSES


Primary hypertrophic osteoarthropathy

17

Cause of Diffuse SOLID Perioteal rxn:

Clinical triad of digital clubbong, periositis, synovitis

Found in bronchogenic carcinoma patients

95% of cases

Secondary hypertrophic osteoarthropathy

18

Cause of Diffuse SOLID Perioteal rxn:

Usually seen after tx for hyperthyroidism when pt are euthyroid or hypothyroid.

Pt shows exopthalmos, digital clubbing pretibial myxedema and periostitis

Thyroid acropachy

19

Cause of Diffuse SOLID Perioteal rxn:

Uncommon disorder of infancy usually middle of the first year characterized by sudden onset of fever, hyperirratibility and swelling especially over the mandible!

Infantile cortical hyperostosis AKA Caffey's disease

20

Cause of Diffuse SOLID Perioteal rxn:

Acute overdose of vitamin A associated with nausea, vomitting, headache and irratibility.

Periostitis involving tubular bones especially the ulna and metatarsals

NOT in mandible

Hypervitaminosis A

21

Cause of Diffuse SOLID Perioteal rxn:

Periostitis occurs in children related to subperiosteal bleeding

Capillary fragility related to hypovitaminosis C

Gum bleeding

Scurvy

22

Cause of Diffuse SOLID Perioteal rxn:

Mutliple areas of solid periosteal new bone associated with multiple fractures at different stages of healing

Battered children

23

Cause of Diffuse SOLID Perioteal rxn:

Excessive growth hormone production stimulating solid periosteal bone formation

Acromegaly

24

Cause of Diffuse SOLID Perioteal rxn:

Multiple areas of bone desrtuction associated with adjacent periostitis

Leukemia

25

Cause of Diffuse SOLID Perioteal rxn:

Young children under two years show normal physiological new bone formation

Normal

26

Periosteal rxn:

Demonstrates multiple concentric parallel layers of new bone adjacent to the cortex

May transform to solid but never form full cortex

Mostly in diaphysis

Laminated

27

Causes of laminated rxn

Ewing (Classic cause)

Eosiniophilic granuloma

Osteomyelitis

leukemia

28

Top 5 primary malignant bone cancer?

MOCEF

Multiple myeloma

Osteosarcoma

Chondrosarcoma

Ewings

Fibrosarcoma

29

T/F: Osteomyelitis can produces any periosteal rxn

True

30

Periosteal rxn:

Most aggressive

Fine, linear spicules oriented perpendicular to cortex

Parallel or radiating

Rapidly growing lesions(5-6 weeks)

Characteristic of Osteomasarcoma

Spiculated AKA
perpendicular, brushed whiskers, hair-on-end, and sunburst