Definition

What is periostitis?

Periostitis is an inflammation of the periosteum which is the dense connective tissue protecting and securing muscle fibers to the bone tissue. In such a condition, the patient experience an inflammation, tenderness and swelling around one or more bones. Usually periostitis occurs when there is an injury, severe infection, cancerous condition or any autoimmune disorder that damages a layer of periosteum.

Periostitis is usually benign and well-tolerated. It can also take other forms, though, including an infectious condition that’s much more serious and may require more intensive therapy.

There are various forms of periostitis which can be classified as below.

  • Simple Periostitis: This is the type of periostitis which develops with bruises and broken bones and the presence of the inflammation is focused near the periosteneum. Pain and swelling can be the initial symptoms here.
  • Simple Fibrous Periostitis: Simple fibrous periostitis is characterized by thickening of the horny periostenum due to prolonged irritant.
  • Suppurative Periostitis: This is the type of periostitis which grows when there is a penetration of infection from neighbouring purulent focus of injury or peristoneum. Fever, extreme swelling, pain etc are some common symptoms of suppuratuve periostitis.
  • Albuminozny Periostitis: Sometimes the chronically affluent abscess in periostitis can cause congestion at the periosteum of sero mucous fluid and is known as Albuminozny periostitis.
  • Periostitis Ossificans: In chronic stimulation of the periostenum, there occurs an excessive outgrowth of the bone and known as Periostitis ossificans.

How common is periostitis?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of periostitis?

People who suffer from periostitis can experience the following symptoms:

  • Difficulty bearing weight on affected limb
  • Pus forming
  • Intense pain in affected area
  • Fever
  • Chills
  • Swelling of tissue around bone
  • Pain in front part of tibia
  • Bone tenderness
  • Stiffness, especially when getting out of bed in morning

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you or your loved one has any signs or symptoms listed above or you have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes periostitis?

The causes of periostitis vary depending on whether the condition is acute or chronic.

Causes of acute periostitis

Acute periostitis can develop from a variety of infections in other parts of the body. For example, a urinary tract infection or a sexually transmitted disease, such as syphilis, could lead to periostitis. The same is true for a cut that doesn’t heal and gets deeper, eventually reaching the bone.

People who have chronic ulcers, such as people with diabetes or people who are immobile and develop pressure sores, are more likely to develop periostitis. This is especially the case if the ulceration doesn’t heal or is allowed to continue to develop. Certain autoimmune diseases can lead to acute periostitis. Leukemia and various cancers and blood disorders are all potential conditions that can lead to serious bone infections.

Proliferative periostitis, or osteomyelitis, is one type of bone infection. Staphylococcus or and other similar bacteria is usually the cause. Staphylococcus bacteria are present in healthy people. They’re considered a part of the normal bacteria that reside on the skin and the nose. This type of bacteria may also cause infections of the skin, especially in people who have weakened immune systems or chronic underlying illnesses. If you don’t get treatment for an infection due to Staphylococcus or related bacteria, you may get osteomyelitis. Osteomyelitis is an infection of the bone itself.

Causes of chronic periostitis

Repeated stress on your bones can lead to chronic periostitis. Athletes and people who frequently jump, turn, or lift weights are at an increased risk of developing shin splints. The repetitive stress that these activities places on your bones can lead to the inflammatory changes that are responsible for periostitis.

Risk factors

What increases my risk for periostitis?

Risk factors for acute periostitis include having any systemic infection, joint replacement surgery, poor circulation, and having an open fracture where the bone pierces through the skin.

Chronic periostitis risk factors include being an athlete or being a person who drastically increases their exercise regime or having Osgood-Schlatter disease which is common among growing children. Osgood-Schlatter disease is inflammation of the knee and results in swelling and chronic pain.

Please consult with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is periostitis diagnosed?

There are different ways to diagnose periostitis. As your doctor conducts a physical exam, they will rule out other conditions such as fracture, Lyme disease, arthritis, Hypertrophic Pulmonary Osteoarthropathy, Caffey’s disease, and other potential ailments.

Here’s a rundown of the different procedures that might be conducted to determine if you have periostitis.

  • X-Ray—this can eliminate the possibility of a stress fracture
  • MRI—can expose stress fractures as well as localized edema where muscles are attached to the bone.
  • Bone scan—shows high blood flow and activity level in the shinbone. Is very effective in confirming periostitis.

A physician will look for tenderness, swelling, and redness along with the different diagnostic tests. A detailed review of patient medical history can also help in coming to a final diagnosis.

How is periostitis treated?

Your treatment options depend on the type of periostitis you have.

Treatment for acute periostitis

Doctors use antibiotics to treat the underlying infection of acute periostitis. If the infection becomes suppurative, or produces pus and fluid, your doctor may need to drain it surgically.

Your doctor may also have to remove any bone tissue that becomes necrotic from infection. Doing this can prevent the spread of infection. This is called surgical debridement.

Treatment for chronic periostitis

For shin splints and similar stress-related injuries, try rest and ice. Take a break from high-impact activities, such as running or jumping, and go with more low-impact exercises, such as biking or swimming. Applying ice can bring down swelling and reduce inflammation. Taking an anti-inflammatory medication such as ibuprofen (Advil) may also help.

If home remedies don’t work, you may have a more serious underlying injury that requires physical therapy. You may need a steroid injection to reduce inflammation in your knee or other joint. In general, though, resting the affected area should ease symptoms.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage periostitis?

Research suggests that following a diet containing antioxidant-rich fruits and vegetables can help people with shin splints. Vitamin E, omega-3 fatty acids, and selenium are known to help the body fight inflammation. Foods like whole-grain bread, nuts, and salmon are beneficial. You can also consider multivitamins to ensure you get the essential nutrients your body requires.

Periostitis can be painful. However, in the majority of cases, the outcome is positive with proper treatment. Not returning to a normal level of activity immediately following treatment can help you avoid future episodes. The best approach is to get the go-ahead from your doctor before resuming your usual physical routine. Remember, once you do get the okay, increase activity gradually so you don’t reinjure yourself.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: March 9, 2018 | Last Modified: March 9, 2018

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