Abstract
Periosteum is a multipotential membrane giving rise to variety of reactions when mineralized. Any stimulus mechanical, physiological, biological and pathological stimulus can produce periosteal reaction and is best seen on conventional films. However, in order to detect early periosteal reaction, Ultrasonography is the mode of choice of investigation. There is a spectrum of imaging findings but no one really is specific. The number of etiological factors as well as the number of imaging features are listed and described. The message is that periosteal reaction is a radiological sign and not a disease, although is encountered in many focal, multifocal and systemic disorders.
Highlights
The periosteum is a multi potential membrane and the cells give rise to a variety of reactions to various stimuli and is said to be a magic sleeve for the bone. Like the skin it swells, cracks and proliferates reacting to stimuli such as injury, inflammation, infection, metabolic disorders, toxic substances, primary and secondary neoplasms
Traumatic In the healing process of a fracture periosteal reaction is noted as a reparative process
Ultrasonography is sensitive in detecting early periosteal reaction
Summary
The periosteum is a multi potential membrane and the cells give rise to a variety of reactions to various stimuli and is said to be a magic sleeve for the bone. Traumatic In the healing process of a fracture periosteal reaction is noted as a reparative process Starting as unilaminar, it evolves into compact lesion [5]. Shin splints - Medial tibial stress syndrome, inflammatory changes occur along inner aspect of shin bone, which may result in tibial traction periostitis [8] Insufficiency fractures These occur when there is poor bone such as seen in old age, steroid therapy and other causes of osteoporosis (Figure 5g). Fungal, spirochetel and parasitic organisms may induce early osteomyelitis and produce reactive periosteal reaction In acute type, it is generally laminar and in subacute it is compact (Figure 7a-d). In chronic osteomyelitis thick irregular and compact periosteal reactions are noted (Figure 7e-i). In reactivation of chronic osteomyelitis linear periosteal reaction may be seen when there is activity. Figure 9a: Congenital syphilis periosteal reaction along the (a) femora and (b) radius
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