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Periosteum of tibia
Last reviewed: 23.04.2024
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The periosteum of the tibia can be acute, subacute or prolonged for a long time. In addition, it is necessary to distinguish the following forms of pathology, the basis of division of which is the causative factor, structural changes and clinical manifestations of the disease.
So, divide into simple, purulent, fibrous, and also serous, based on the form of the inflammatory reaction. In addition, ossify, tuberculosis and syphilitic periostitis are isolated.
Periostitis is an inflammatory reaction of the periosteum to the effect of a damaging factor. The pathological process can affect many bones, but now we are talking about periostitis of the shin. The onset of the disease is noted in one of the layers of the periosteum (internal or external) with subsequent spread to other layers. In addition to the periosteum due to the proximity of the bone, the latter is also involved in the inflammatory process.
[Causes of periostitis of the lower leg
Based on the clinical forms of manifestation of periostitis, there are several leading causes that trigger the onset of inflammation in the periosteum. Most often, the disease is noted in professional athletes and people subjected to significant physical stress.
As for athletes, it is important to choose the right sports shoes and strictly monitor the loads. It is inadmissible to sharply increase the load and change the surface of the track. The reasons for the periostitis of the shin in this case will be the unprofessional approach of the trainer to the training of the athlete.
Inflammation in the periosteum can be provoked by various bruises, traumas, a rapid increase in the load on an unprepared organism, the start of occupations with excessive physical exertion without a previous warm-up or other preparation.
In addition, the causes of periostitis of the shin may consist in muscle weakness, debilitating physical exertion, prolonged resting on the forefoot, as well as prolonged running uphill along an inclined surface.
Do not forget about a disease like tuberculosis, which can affect not only the lungs, but also other organs. The causative agent of a tuberculosis with a current of blood from the nearest pathological focus spreads through the body and can attack the periosteum, causing the onset of an inflammatory process.
The cause of periostitis can be tertiary syphilis, which affects the diaphysis of the tibia. As a consequence, there is a significant, sometimes symmetrical thickening of the bone structure.
Symptoms of a leg periostitis
Depending on the cause of the inflammatory reaction from the periosteum, as well as structural changes, it is necessary to distinguish between the clinical manifestations of each individual form. So, a simple form of inflammation often develops as a result of the influence of a traumatic factor, as a result of which aseptic inflammation is noted, that is, without an infectious agent.
It is symptomatic to allocate pain syndrome and swelling of the tissues over the affected area of the periosteum. Most often this type of inflammation is recorded in the tibia. In most cases, periostitis is self-cured and does not leave any consequences, but it is possible to form osteophytes.
Fibrous type of inflammatory process in the periosteum is characterized by a chronic course, the cause of which is a constant irritation of the periosteum. A similar condition is observed with ulcerous lesions of the tibia, necrosis of the bone structures and in the presence of a chronic course of arthritis. Forming fibrous tissue can provoke the destruction of bones. The regress of the pathological process is noted in the event that the negative provoking factor is eliminated.
Inflammation of the periosteum of a purulent nature develops as a result of infection of the periosteum due to a penetrating injury or by the spread of pathogenic microorganisms from a number of located tissues. Symptoms of the periostitis of the tibia with purulent inflammation are expressed by an acute onset, hyperthermia up to 39 degrees and concomitant chill.
Serous inflammation is characterized by the formation of exudate, the accumulation of which is noted under the periosteum. Exudate has a lot of protein (albumin). The amount of accumulated liquid can reach 2 liters, which contributes to the peeling of the periosteum from the bone with further necrosis of the latter. Symptoms are the presence of pain and the appearance of swelling of tissues surrounding the pathological focus. The temperature can rise slightly and independently normalize.
Ossifying the chronic inflammation of the periosteum is noted due to the action of the irritating factor. In the area of inflammation, there are proliferations of bone tissue. Pathological bone formation stops as soon as the pathological effect of the provoking factor is eliminated. In the case of rapid disease, delamination of the periosteum with the appearance of purulent exudate is possible. In some cases, the accumulation of a large amount of pus can lead to a rupture of the periosteum, after which the process of bone formation begins, which contributes to the progression of the pathological process.
The periodicity of tuberculosis etiology is most often due to the spread of the infectious process from a closely located pathological focus. As for tertiary syphilis, here the periostitis is most often localized on the diaphysis of the tibia. As a result of thickening of the bones, sometimes even a symmetrical process, bone "growths" are visualized on the roentgenogram. Symptoms of periostitis of the tibia in syphilitic lesions are as follows: pain syndrome is characterized by an increase in intensity at night, swelling of the soft tissues during palpation is dense-elastic, and the shape may be round or fusiform. Skin covers are not subject to significant changes. Gunma in rare cases undergoes destruction with a breakthrough and a further ulcerative defect.
Where does it hurt?
Diagnostics of leg periostitis
When a patient seeks a doctor, a detailed survey of the complaints that are currently bothering him is carried out first. In addition, it is necessary to find out when and under what circumstances the symptoms first appeared. A detailed survey will help in the search for the causes of the development of pathology, as well as in the formulation of a preliminary diagnosis.
On the basis of clinical symptoms and objective examination, some leading syndromes can be identified, which also contributes to rapid diagnosis. Next, we need to start instrumental and laboratory research.
For example, in the presence of purulent exudate, in addition to the acute onset of the disease and high temperature in the blood, an increased number of leukocytes is found. In addition, as accumulation of pus accumulates under the periosteum, there is a fluctuation above the affected area.
Diagnostics of the periostitis of the shin also includes the radiography of the pathological focus for determining the area and nature of the disease. In the case of tuberculous lesion, the lungs, lymph nodes and adjacent organs should be further investigated. In the blood there may be a low level of leukocytes.
With syphilitic periostitis, most often the diaphysis of the tibia is affected, resulting in a significantly thickened bone. Sometimes this process can take place symmetrically. Clinically, syphilitic lesions are manifested by pain sensations, which are characterized by an increase in intensity at night. The swelling to the touch is dense-elastic, round or spindle-shaped. In rare cases, gum decays with further breakthrough and formation of a ulcerative defect.
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Treatment of leg periostitis
When there is pain in the shin area, it is not recommended to continue training, even with a decrease in intensity after a short break. Exception of physical activity is not the only therapeutic method for periostitis.
Treatment of periostitis of the shin involves the use of a special set of exercises, the purpose of which is to strengthen the muscles. Due to it there is no muscular overload and the progression of periostitis. Such exercises as transferring body weight to socks and walking on the toes, can be performed even with pain sensations. If the pain is absent, then you should add to the complex of physical exercises the swelling of the shins and the hips. In a small amount you can perform running on straight legs. It is necessary to perform all exercises with gentle movements of the feet.
With intensive physical exertion, a persistent inflammatory process develops. It manifests itself as painful sensations that can become more intense or disappear, which does not mean that the inflammation does not decrease at all. In addition, some athletes with a decrease in pain syndrome return to the previous workload. Thus, the injured periosteum may be re-injured, which aggravates the process of recovery.
Treatment of periostitis of the shin takes a fairly long period of time, so that the return to greater physical exertion can lead to an exacerbation of the disease and a delay in the recovery.
In the case when the inflammatory process is not expressed, the patient adheres to the prescribed regimen and applies ointments with a warming effect, then soon one can achieve regress of periostitis and resume training, but after reviewing the load.
Running with inflammation of the periosteum should not be carried out at a fast pace (at a speed of no more than 1 kilometer in 7 minutes). In addition, it must be borne in mind that the surface for running should not be solid. For this purpose, it is good to use the terrain with sand, lawn or loose earth, and then go to the compacted soil and an even harder surface. Return to the previous physical loads after recovery should be done smoothly, always starting with a warm-up and slowly increasing the intensity.
Treatment of periostitis of the lower leg in a more severe form can not be limited only by reducing physical exertion and warming ointments. In this case, the traumatologist must be concluded at the stage of the disease and further therapy with the use of physiotherapeutic and other procedures.
Treatment of periostitis of the tibia by alternative means
Alternative medicine can be used as a monotherapy or in addition to the main therapeutic directions of traditional medicament approaches.
Used natural herbs provide anti-inflammatory effect, reducing flushing, swelling and pain syndrome. In addition, they help the bone structures to regenerate and restore the old form faster.
Treatment of periostitis of the tibia by alternative means can be carried out by the comfrey common. It has a huge set of biologically active substances that help treat not only periostitis, but also many other pathologies of bones and joints.
So, comfrey has allantoin, alkaloids, lipospermic acid and other phenolic carboxylic acids, phytosterols and pyrocatechol tannins. Inside the decoction of the comfrey is taken with an anti-inflammatory purpose in the pathology of the respiratory system, and externally - with fractures, dislocations and other diseases of bones and joints.
To prepare the ointment, you must melt 0.1 kg of butter (creamy) with the help of a water bath and add the root crushed almost to powder (also 100 g). Stirring, it is necessary to warm up in a water bath and leave for half an hour. After cooling, it is necessary to lubricate the pathological focus, and the ointment itself can be stored in the refrigerator.
At the end of the acute phase, the treatment of periostitis of the tibia by alternative means can be carried out with the Adam's root. To make a tincture for grinding, grind the root of 200 g and pour half a liter of vodka. Insist root should 5 days in a dark place. Once the tincture is ready, it is necessary for it to rub the affected area for the night and cover with a warm kerchief.
If the heating is carried out with an active inflammatory process, the risk of even more activating the process and spreading to the surrounding healthy tissues increases.
Prophylaxis of the periostitis of the lower leg
In order to avoid or reduce the risk of inflammation of the periosteum, it is necessary to adhere to some recommendations. This is especially true for athletes who have a busy schedule of training, which is why they have the highest probability of pathology. However, the occurrence of periostitis in other people is not excluded.
Thus, physical exercises should be carefully selected in view of the fact that shock drills when running on a hard surface can trigger the emergence of a lesion in the periosteum.
Prevention of periostitis of the tibia has another effective method. It consists in gradually strengthening the muscles of the shin by performing a specially selected course of physical exercises, the main of which are jumping and running.
Particular attention should be paid to the selection of shoes for training. It should be of appropriate size, so that it does not cause uncomfortable sensations in the process of performing physical exercises. In addition, shoes should be soft to avoid microtraumatism of bone structures. Professional athletes are advised to strictly follow the training schedule, as it is selected individually, taking into account the features and capabilities of the body.
Forecast of periostitis of the lower leg
The prognosis of the further development or regression of the pathological process depends on the correctness of the person's implementation of the recommendations. How thoroughly he will observe the recommended regime of training and physical exertion, recovery will come so quickly.
Depending on the severity of the disease, the periostitis perineal run may be of a different nature. In most cases, the disease ends in recovery if the treatment regimen is observed. However, there are cases when the pathology passes into a chronic form with frequent exacerbations.
The recurrent course is due to an incompletely cured pathological process. As a result, clinical symptoms occur again and again. The process of restoring the normal structure of bones takes a long time, since the regeneration process does not differ fast.
The prognosis of the periostitis of the shin largely depends on the approach to the treatment of the athlete and the coach. Correctly selected physical exercises can strengthen the muscles of the shin and prevent the progression of the inflammatory process in the periosteum. It is better for several months to give up intensive workloads, than in the future to suffer from constant recurrences of chronic periostitis of the shin.
Periostitis of the tibia is a frequent pathology, but not always it is timely diagnosed, which leads to progression and deterioration. In order to avoid this, it is recommended to exercise dosedly, gradually strengthening the muscles, and also to choose a special footwear for training.