Periostitis

Periostitis is an inflammatory process that occurs in the periosteum of the bone.

Padding is a connective tissue in the form of a film that is located on the entire surface of the outside of the bone. As a rule, the inflammatory process begins in the outer or inner layers of the periosteum, and then penetrates into the other layers of the periosteum.

Due to the fact that the periosteum and bone are closely connected, the inflammation easily appears in the bone tissue and is called osteoperiostitis.

ICD-10 code

ICD is an international classification of diseases and various problems associated with a health disorder.

At the moment, the tenth version of the International Classification of Diseases document, called ICD-10, is in operation worldwide.

Different types of periostitis received their codes in this classification:

Periostitis of the jaws - belongs to the class K10.2 - "Inflammatory diseases of the jaws":

• K10.22 - purulent, acute periostitis of the jaw
• K10.23 - chronic periostitis of the jaw

Class M90.1 - "Periostitis in other infectious diseases classified elsewhere":

• M90.10 - multiple localization of periostitis
• M90.11 - periostitis with localization in the shoulder region (collarbone, scapula, acromioclavicular joint, shoulder joint, sternoclavicular joint)
• M90.12 - periostitis with localization in the shoulder (humerus, elbow joint)
• M90.13 - Periostitis with localization in the forearm (radius, ulna, wrist joint)
• M90.14 - periostitis with localization in the wrist (wrist, fingers, pastern, joints between these bones)
• M90.15 - Periostitis with localization in the pelvic region and thigh (gluteal region, thigh, pelvis, hip joint, sacroiliac joint)
• M90.16 - periostitis with localization in the tibia (fibula, tibia, knee joint)
• M90.17 - periostitis with localization in the ankle and foot (metatarsus, tarsus, toes, ankle and other joints of the foot)
• M90.18 - other periostitis (head, skull, neck, ribs, trunk, spine)
• M90.19 - periostitis with undefined localization

Causes of periostitis

The causes of periostitis are as follows:

1. Various kinds of trauma - bruises, dislocations, fractures of bones, ruptures and stretching of tendons, wounds.
2. Inflammation of nearby tissues - as a result of an inflammatory focus next to the periosteum, periostitis becomes infected.
3. Toxic - this is the cause, which is the effect of toxins on the tissue of the periosteum. Some types of common diseases can provoke the appearance of toxins in the patient's body and their penetration into the periosteum. Toxins come from the diseased organ into the circulatory and lymphatic system and with their help are carried throughout the body.
4. Specific - inflammation of the periosteum occurs as a result of certain diseases, for example, tuberculosis, syphilis, actinomycosis and so on.
5. Rheumatic or allergic - the reaction of the periosteum tissue to allergens that penetrated it.

[1], [2], [3]

Pathogenesis of periostitis

The pathogenesis of periostitis, that is, the mechanism of its appearance and course, is of several kinds.

1. Traumatic periostitis - occurs as a consequence of all possible injuries of bones affecting the periosteum. Traumatic periostitis can manifest itself in acute form, and then, if the treatment is not on time, go into a chronic form.
2. Inflammatory periostitis is a kind of periostitis that occurs as a result of inflammation of other nearby tissues. For example, this kind of periostitis is observed with osteomyelitis.
3. Toxic periostitis - arising from exposure to the periosteum of toxins that enter it with a blood or lymph flow from other lesions. This kind of periostitis appears with some common diseases of the body.
4. Rheumatic or allergic periostitis - arise as a result of allergic reactions of the body to certain factors.
5. Specific periostitis - caused by certain diseases, such as tuberculosis, actinomycosis and so on.

Symptoms of periostitis

Symptoms of periostitis depend on the type of periostitis. Consider the reaction of the body with aseptic and purulent periostitis.

Symptoms of aseptic periostitis are expressed in the following:

1. Acute aseptic periostitis is characterized by the appearance of swelling, which is weakly limited. When you feel the swelling there are strong painful sensations. This increases the local temperature in the affected area. When this form of periostitis appears on the limbs, lameness of the supporting type can be observed, that is, a violation of the support function.
2. Fibrous periostitis is characterized by a limited form of swelling. At the same time, it has a dense consistency and is almost not painful or does not deliver painful sensations at all. The local temperature on the affected area remains unchanged. And the skin covers over the lesion get mobility.
3. Ossifying periostitis manifests itself in the swelling, which has sharply limited outlines. Its consistency is solid, sometimes with an uneven surface.

Painful sensations do not appear, but the local temperature remains normal.

With all kinds of aseptic periostitis, the general reaction of the body to the appearance of the disease is absent.

With purulent periostitis, there is a different reaction of the organism. Manifestations of purulent periostitis are characterized by strong local disorders and changes in the state of the whole organism. There is an increase in body temperature, the pulse and breathing of the patient becomes more frequent, the appetite disappears, weakness, fatigue and general depressed state appear.

The swelling is very painful, hot, there is an increased tension in the tissues of the inflamed area. Possible edema of soft tissue in the site of inflammation of the periosteum.

Jaws periosteum

Periostitis of the jaw is an inflammatory process that occurs in the alveolar process of the upper jaw or the alveolar part of the lower jaw. Periostitis of the jaw arises from the sick teeth: untreated or unidentified periodontitis or pulpitis. Sometimes the inflammatory process begins due to infection from other diseased organs with blood or lymph flow. If treatment does not occur on time, then periostitis provokes the appearance of a fistula (or flux) on the gum. Purulent inflammation can spread from the periosteum to the tissues that surround the lesion, resulting in an abscess or phlegmon.

Sprout teeth

The periosteum of the tooth is a kind of periostitis, in which there is an inflammatory process of the tooth tissues, which in everyday life is called a flux. This disease occurs, mainly because of untreated tooth decay. As a result, the infection penetrates the tooth, provoking the appearance of periostitis.

The periostitis of the tooth is accompanied by strong unpleasant symptoms, the main one of which is a powerful intolerable toothache. It is also possible the appearance of local or general body temperature, chills and weakness.

Peridostite of the bones

Periostitis of bones or osteoperiostitis is an inflammation of bone tissue caused by inflammatory processes in its periosteum. Since the periosteum and bone tissues are adjacent to each other, the lesion is expanded.

The causes of osteoperiostitis can be pathogenic microorganisms. Diseases of an infectious nature are one of the causes of periostitis of the bone. These provoking osteoperiostitis include: osteomyelitis, bone tuberculosis, syphilis and other diseases.

Periostitis of the periosteum

This inflammatory disease of the periosteum, which is caused by various injuries or infection is a certain part of the periosteum.

Causes of periostitis of the periosteum can be various bruises, sprains and ligament ruptures, bone fractures, the consequence of which is inflammation of the periosteum.

Also, the inflammation of the periosteum can be infectious in nature, for example, if it enters a pathological microflora in an injured area. Also, various infectious diseases can contribute to the appearance of periostitis, when pathogens through the flow of blood or lymph enter the periosteum from the focus of inflammation.

Periostit feet

This is a lesion of the periosteum of the bones of the legs of an inflammatory nature. Usually, they arise due to various leg injuries - soft tissue injuries, sprains, bone fractures, joint dislocations and so on. Various injuries are caused by mechanical damage to the periosteum of the leg bones, and then its inflammation.

The tibia is the most prone to periosteasis. This bone is most affected by injuries to athletes and soldiers in the early period of service. Running on hard ground, crossed terrain and so on can injure the tibia and its periosteum. As a consequence, the appearance of acute or chronic forms of aseptic periostitis is possible.

At the very beginning of the disease, a slight swelling appears on the posterior surface of the first third of the shin, which when felt causes painful sensations in the leg. At the onset of the onset of the disease, no changes in the bone can be detected using an X-ray examination. But after twenty or thirty days in the pictures, you can see small seals on the inner surface of the tibia.

Periosteum of tibia

Inflammatory process, which appeared in the periosteum of the shin. The lesion appears in the outer or inner layers of the periosteum, and then spreads to all the tissues of the periosteum.

The causes of periostitis of the shin are:

• injuries - bruises, fractures of bones, stretching of tendons;
• biomechanical problems, most often excessive pronation;
• errors in training and excessive workload;
• incorrectly selected shoes;
• surface roughness, which is used for training, usually in running.

The first symptoms of periostitis of the periosteum of the shin are the appearance of swelling. Infusional infusions can be accompanied by painful sensations in the lesion and an increase in body temperature.

Periostitis of the knee joint

Inflammatory processes in the periosteum of the bones forming the knee joint. This is due to injury of the joint bag, stretching and rupturing of the ligaments of the joint. Inflammation of the perioste leads to the appearance of swelling on the bone, which is painful on palpation. Appears edema of the nearest tissue, which makes it difficult to move in the joint.

Usually, the periostitis of the knee joint develops into a chronic form, which provokes the formation of various growths and seals on the bone that impede movement. Also, periostitis of the knee joint is most often accompanied by manifestations of osteoperiostitis of the bones forming this joint.

Periostit stops

The defeat of the periosteum of the foot bones is inflammatory. The most common causes of periostitis are trauma (bruises, dislocations, sprains and ligament ruptures). Constant loads also relate to the causes of periostitis of the foot - as a result of constant irritation of the periosteum and microtraumas, inflammatory processes and changes in the tissues of the periosteum occur.

The periostitis of the feet is accompanied by the following symptoms: sharp pain when loaded on the foot, swollen soft tissue, thickening on the bones of the foot, which can be painful or painless when palpating.

Periostitis of metatarsal bone

It is an inflammatory process in the periosteum of one metatarsal (metacarpal) or several metatarsal (metacarpal) bones. Typically, periostitis of the metatarsal bone is due to a trauma (traumatic periostitis) or a constant load on metatarsal bones (loading periostitis).

Posterostites of metatarsal bones also appear as complications in longitudinal flatfoot. Or women who constantly wear high heels.

The main symptoms of periostitis of the metatarsal bone are the appearance of sharp pains, especially when loading on foot or walking; swelling of the feet; the appearance of seals when palpating the metatarsal bones.

Periostitis of the nose

Inflammatory processes that form in the periosteum of the bones of the nasal sinuses. Most often, the occurrence of such a periostitis is associated with previous injuries. For example, a fracture of the bones of the nose can subsequently lead to inflammation of the periosteum. Also, the inflammatory processes that occur in the nasal sinuses and other parts of the nasopharynx can cause inflammation of the periosteum.

Symptoms of a periostitis of a nose are change of its form, occurrence of painful sensations which amplify at palpation of a nose.

When diagnosing periostitis, it is important to ascertain the resulting injury or permanent injuries, for example, in boxer athletes.

Periostitis eye sockets

These are inflammatory processes in the periosteum of the orbit. Usually, the periostitis of the orbit appears along with the inflammation of the bone and is called osteriostitis.

There is a periostitis of orbits in different parts of it. Usually, it is serous or purulent, sometimes with the appearance of an abscess.

The causes of the disease can be pathogenic microorganisms - streptococci, staphylococci, in more rare cases - tuberculosis microbacteria and spirochaeta.

Most often, periostitis appears as a complication in inflammation of the nasal sinuses and when furuncles appear on the face code. Sometimes periostitis eye sockets cause infectious diseases - tonsillitis, influenza, scarlet fever, measles and so on. Among the causes of periostitis of the orbit can also be dental caries, dacryocystitis and trauma to the periosteum of the orbit.

The manifestations of periostitis in this case are as follows: swelling in the anterior part of the orbit, which is painful when pressed; edematous skin in this area, which has a higher temperature than neighboring ones; edema of the mucous tissue of the eyelids; conjunctivitis.

The disease can be acute - develop within two or three days. Perhaps a sluggish manifestation of the disease, for several weeks.

Periostite of orbits

Another name is the periostitis of the orbit. There are two forms of periostitis of the orbit:

• Simple or nasty.
• Purulent.

A simple periostitis of the orbit occurs as a result of acute inflammation of the nasal sinuses, which were the consequences of the transferred flu, scarlet fever and other infectious diseases. This process is reversible, and is the appearance of hyperemia and serous cell infiltration of the periosteum. Outwardly it looks like a slight swelling of the periosteum. Under favorable conditions for the development of periostitis, a connective callus is localized on the periosteum on the orbital bone. Then there is a fusion of the periosteum with bone, that is, the formation of fibrous corns.

Purulent periostitis is a consequence of mere periostitis or is provoked by the existing deep caries of the bone wall of the subordinate cavity. Purulent periostitis is manifested by the formation of pus from the serous-cellular infiltration of the periosteum. Initially, these manifestations appear on the inner surface of the periosteum, which is connected to the bone. Later, the pus that accumulated between the periosteum and the bone begins to permeate the inner layer of the periosteum, which flakes off the bone and an abscess appears in the given place.

Periostitis in children

Periostitis in children is a manifestation of inflammatory processes in the periosteum of the jaws. The nature of the disease can be odontogenic or traumatic. The odontogenic nature of periostitis is associated with tooth disease, when the infection enters the periosteum from the inflamed periodontium. Traumatic periostitis appears due to jaw injuries.

By the nature of the course of the disease, periostitis in children can be acute and chronic. Acute periostitis, in turn, is divided into purulent and serous. Chronic periostitis in children is rare, usually in childhood there are acute periostitis.

Classification of periostitis

Classification of periostitis can be of several types.

There are several types of periostitis, which depend on the nature of the inflammatory processes and the causes of their occurrence. The first group of periostitis is exudative, including serous, serous-fibrinous, fibrinous and purulent periostitis. The second group of periostitis is proliferative, including fibrotic and ossifying periostitis. Exudative periostitis, usually, has an acute and rapid course, and proliferative always have a chronic nature.

1. Plain.
2. Ossifying.
3. Purulent.
4. Serous albuminous.
5. Fibrous.
6. Tuberculous periostitis - is characterized by the appearance in the inner layer of periostitis of granulated damaged tissue. Then this tissue is modified into curdled necrotic manifestations or is susceptible to suppurative melting, as a result of which the periosteum is destroyed. Usually this kind of periostitis appears on the ribs and bones of the face.
7. Syphilitic - a lesion of the periosteum, which occurs due to syphilis, which can be congenital or acquired. Syphilitic periostitis happens in two forms - ossifying and gummy. Ossifying form is characterized by the appearance of hyperiostoses (syphilitic nodes on the periosteum). Hummus periostitis provokes the appearance on the bones of gumm - elastic flat thickenings.

According to the duration of the course, two forms of periostitis are distinguished:

1. Acute (subacute).
2. Chronic.

Due to involvement in the inflammatory processes of microorganisms that have arisen, there are periostitis:

1. Aseptic - appear as a result of closed injuries of bones in those places that are not protected by soft tissues.
2. Purulent - are the result of getting into the periosteum of various infections.

[4], [5], [6], [7],

Acute periostitis

Acute periostitis is a kind of periostitis, in which the course of the disease manifests itself in an acute form with purulent inflammatory processes. The occurrence of acute periostitis is due to the penetration of pathogenic microflora into the periosteum.

The first signs of acute periostitis - the appearance of swelling on the periosteum and edema of soft tissues. The appearance of these symptoms is accompanied by painful sensations in the swelling, which rapidly increases in size. Subsequently, the swelling is transformed into a purulent inflammation, the course of which is characterized by an increase in body temperature to 38 - 39 degrees.

[8], [9], [10], [11], [12],

Chronic periostitis

This is a long and slow inflammatory process of the periosteum of the bone. Chronic periostitis is characterized by the appearance of thickening on the bone, which does not deliver painful sensations.

In the X-ray study, it was found that chronic periostitis manifests itself in lesions that have clear limitations. In this case, pathological changes in bone tissue of moderate severity and the appearance of severe hyperplasia in the periosteum are observed.

The development of chronic forms of periostitis is due to untreated acute periostitis, which has been transformed into a chronic disease. There are cases when chronic periostitis does not go through an acute stage, but immediately turns into a slow, long-lasting illness.

Also, specific diseases of the inflammatory infectious nature (tuberculosis, syphilis, osteomyelitis, and so on) can cause chronic periostitis, which lead to complications, for example, the appearance of a chronic form of periostitis.

[13], [14], [15], [16], [17], [18],

Simple periostitis

Acute inflammatory process of aseptic nature, in which there is increased blood flow to the affected part of the periosteum (hyperemia), as well as a slight thickening of the periosteum and the accumulation in its tissues of a fluid that is not characteristic of it (infiltration).

Purulent periostitis

The most common form of periostitis. It occurs as a result of injury of the periosteum and the appearance of infection in it, most often from neighboring organs. For example, a purulent periostitis of the jaw arises from caries of the teeth, when the inflammation is transferred from the bones to the periosteum. Sometimes this kind of periostitis arises from the hematogenous way, for example, with piety. Purulent periostitis always accompanies the manifestation of acute purulent osteomyelitis. Sometimes, it happens that the source of the infection can not be detected.

The purulent periostitis begins with an acute condition. Hyperaemia of the periosteum develops, in which exudate is formed - a fluid saturated with proteins and blood elements. There is a high body temperature, about 38 - 39 degrees, chills. In the affected area, a thickening is felt, which is painful when pressed. After this there is a purulent infiltration of the periosteum, as a result of which it is easily torn away from the bone. The inner layer of the periosteum becomes loose and filled with pus, which then accumulates between the periosteum and the bone, forming an abscess.

With purulent periostitis, inflammation of the soft tissues and skin of the patient associated with the periosteum can occur.

Serous periostitis

Serous (albuminous, slimy) periostitis occurs after various injuries. On the injured area of the periosteum, there is a swelling along with painful sensations in it. At the onset of the disease, the body temperature rises, and then normalizes. If the inflammatory process is observed in the articular region, this can lead to a decrease in its mobility. In the first stage of serous periostitis, the swelling has a dense consistency, but then softens and can become liquid.

There are subacute and chronic forms of serous periostitis. In each of these cases, the inflammation of the periosteum leads to the formation of exudate, which is localized under the periosteum in a bag similar to a cyst or in the periosteum itself. It has the appearance of serous-mucous viscous fluid. It contains albumins, as well as inclusions of fibrin flakes, purulent bodies and cells in the state of obesity, erythrocytes. Sometimes the liquid contains pigments and fatty drops. The exudate is in a shell of granulated fabric of brownish-red color, and on top is covered with a dense shell. The amount of exudate can reach two liters.

If the exudate accumulates on the outer surface of the periosteum, it can cause swelling of the soft tissues that show up in their swelling. Exudate, which is located under the periosteum, provokes its detachment from the bone. This leads to the fact that the bone is bare and necrosis occurs, when cavities appear in the bone, filled with granulated tissue and microorganisms with weakened virulence.

Fibrous periostitis

Fibrous periostitis has a chronic form of percolation and a long process of injury. It develops over many years and is characterized by the appearance of a corpuscle fibrous thickening of the periosteum, which is strongly associated with bone. If the fibrous deposits are significant, this can lead to the destruction of the surface of the bones or the appearance of new formations on it.

[19], [20]

Linear periostitis

This is the configuration of the periostitis, which is revealed on an x-ray study. Linear periostitis on the X-ray image looks like a single line, located along the bone. There is a linear blackout in the form of a strip (ossification) along the edge of the bone. This form of periostitis is observed in the inflammatory process, which develops slowly and gradually. For example, linear periostitis is observed in syphilis, which occurred at an early age, in childhood or in the initial phase of bone inflammation (osteomelitis).

In acute periostitis, the dark linear blackout is separated from it by a light patch. It can be exudate, osteoid or tumor tissue. Such manifestations in the X-ray image are typical for acute inflammatory periostitis - acute periostitis, exacerbation of chronic osteomyelitis, the primary stage of appearance in the period of bone callus or for a malignant tumor.

With further observations, a bright band may become wider, and a darker one may disappear altogether. Such manifestations are characteristic for hyperostosis, when the formations in the perioste merge with the cortical layer of bone.

Ossifying periostitis

It is due to a simple periosteum due to the constant irritation of the periosteum and is a chronic form of this disease. Characterized by the deposition of calcium salts in the periosteum and bone formation from the inner layer of the periosteum. This kind of periostitis can proceed independently or be accompanied by inflammation of surrounding tissues.

Retromolar periostitis

A disease that is caused by acute pericoronitis. With the progression of this disease inflammation of the periosteum occurs in the retro-molar area.

In the future, under the periosteum, an abscess occurs, along the edges of which there is inflammation of the soft tissues. The area of the wing-jaw folds, the front palatal arch, the soft palate, the anterior edge of the jaw branch, the mucosa of the fold over the external oblique line in the region of the sixth to the eighth tooth suffers. There may be pain in the throat.

A few days after the appearance of the abscess from the inflamed shell around the eighth tooth begins to appear pus. Sometimes the abscess does not open in this area, but spreads along the external oblique line to the level of premolars and forms a fistula in this area. Sometimes the abscess can be opened and in the maxillofacial groove also in the form of fistula formation.

The acute phase of retro-molar periostitis is accompanied by an increase in body temperature to 38 - 38.5 degrees, trismus of the jaws, difficulty in eating food due to this, the appearance of weakness. The acute form of periostitis, if not treated, changes into a chronic phase, which is accompanied by the development of acute cortical osteomyelitis of the jaw.

Odontogenic periostitis

Odontogenic periostitis is an inflammatory process in the jawbones, which is manifested in the inflammation of the periosteum of the jaws. There is odontogenic periostitis due to the penetration of infection from the inflamed tissues of the tooth into the periosteum of the jaw. Such lesions arise due to some diseases of the teeth - caries, pulpitis and periodontitis. The inflammatory process penetrates from the diseased tooth first into the bone that surrounds it, and then onto the periosteum that covers the bone tissue.

Sometimes odontogenic periostitis occurs due to increased blood supply and supply of pulpal lymph, jaw bones and soft tissues during the formation of teeth, their eruption and change, as well as the growth of jawbones during this period.

Load periostitis

This is the inflammatory process of the periosteum of bones, which are regularly increased. For example, the loading periostitis appears on the bones of the foot and legs of the legs, when the patient has to stand on his feet for a long time - to stand, walk or run. This kind of periostitis occurs in athletes engaged in athletics; weightlifters; people who, by their nature, are associated with the constant carrying of heavy loads.

Load periostitis may occur due to injuries, for example, with dislocations.

Symptoms of stressful periostitis are the occurrence of painful sensations with the load on the legs, the appearance of edema of the legs and the appearance of seals on the bones during palpation.

Traumatic periostitis

Damage to the periosteum (traumatic periostitis) is an inflammatory disease of the periosteum, which occurred as a result of any injury. This kind of periostitis is most common in athletes and in people who are constantly training.

It arises from a bruise of soft tissues covering the bone (i.e., the periosteum), when a blow falls on that part of the bone that is poorly protected by the surrounding muscles.

Traumatic periostitis may be a consequence of other diseases, for example, tuberculosis, osteomyelitis, syphilis, malignant tumors and so on. Since these diseases lead to mechanical damage to the periosteum, an aseptic inflammatory process occurs.

Traumatic periostitis has two forms of perforation - acute and chronic.

The clinical picture in the acute form of the disease is very similar to manifestations with bruises. At the site of the injury, a bruise and swelling is formed, which is painful when pressed. Perhaps the appearance of swelling of the nearby tissue, as well as the continued preservation of pain. When examining the patient on the bone, a dense thickening is felt. This kind of periostitis is most common for injuries of the tibia.

The chronic form of traumatic periostitis is manifested in the thickening of the cortical layer of the bone. It is also possible the formation of osteophytes (outgrowths on the marginal bone tissue) and synostosis (fusion of the nearest bones).

Post-traumatic periostitis

This is a form of periostitis that occurs as a consequence of trauma after a bone injury. Also, after fractures, sprains and other injuries, symptoms of post-traumatic periostitis may appear.

In this case, an aseptic inflammatory process occurs in the periosteum, which can lead to acute manifestations of periostitis or to develop into a chronic form. The manifestations of post-traumatic periostitis are similar to the previously described symptoms of traumatic periostitis.

Complications of periostitis

Complications of purulent periostitis are quite severe. If you do not take time to treat it in time, it can lead to inflammatory processes and the destruction of nearby tissues and organs, as well as the whole organism.

A purulent periostitis can provoke the appearance of such diseases as:

1. Osteomyelitis is an inflammatory process of a purulent nature, which leads to necrosis of all tissues of the bone, bone marrow, and surrounding soft tissue bone.
2. Phlegmon soft tissue, located next to the affected bone. This disease is characterized by pus infection and inflammation of the cell spaces and has no clearly delineated boundaries.
3. Soft tissue abcession is a purulent inflammation that has a clear localization and borders.
4. Mediastinitis is an inflammation of the mediastinum, which is of an acute nature, associated with the penetration of the infection.
5. Sepsis is a general severe condition of the body, which is caused by the ingress of animal pathogens and their toxins into the blood and tissues of the patient.

Acute periostitis can go on into a chronic form if treatment has not been performed or if mistakes have occurred during medical procedures.

[21], [22], [23], [24],

Diagnosis of periostitis

Diagnosis of periostitis varies depending on its type and form of percolation.

In acute periostitis, careful examination and questioning of the patient are effective. An important aspect of diagnosis is the results of a general blood test. X-ray examination in this case is ineffective. With a periostitis of the nose, a rhinoscopy is used.

In chronic periostitis, X-rays are used. With the help of an X-ray photograph, it is possible to identify the localization of the lesion, its shape and boundaries, dimensions, and also the nature of the layers. The picture helps to determine the extent of inflammation in the cortical layer of the bone and surrounding tissues, as well as the degree of necrotic changes in bone tissue.

Periostitis can be of various shapes - needle, linear, lacy, fimbriated, comb-like, layered, and others. Each of these forms corresponds to a certain type of periostitis and the complications that it causes, as well as concomitant diseases, for example, a malignant tumor.

[25], [26], [27], [28],

Differential diagnostics

Differential diagnosis of periostitis is used to establish an accurate diagnosis when there are symptoms of several similar diseases.

In acute and purulent periostitis, it is necessary to distinguish it from acute periodontitis, osteomyelitis, abscesses and phlegmon, which were caused by other causes, purulent diseases of lymph nodes - lymphadenitis, purulent diseases of the salivary glands and so on.

In chronic, aseptic and specific periostitis, an X-ray examination is performed. In this case, it is necessary to identify thickening and growths on the bone, necrotic changes and bone tissue tumors that were the consequences of periostitis.

Differential diagnosis of chronic periostitis is carried out simultaneously with the detection of osteomyelitis and malignant tumors by means of X-ray examination. At the peak of the disease, the X-ray examination has a very good validity. With the attenuation of the inflammatory process and its transition to the slow stage, the layers on the bone begin to thicken and acquire a less pronounced stratification. The lesions in the bone also become denser, making it more difficult to diagnose the presence of chronic periostitis.

If the x-ray examination has difficulties with the diagnosis, then in this case they resort to a biopsy.

[29], [30]

Treatment of periostitis

Treatment of periostitis is the timely detection of symptoms of the disease, as well as the following measures.

With the traumatic form of periostitis in the initial stage, the most effective measure will be rest. Used compresses with ice, physiotherapy - UHF, electrophoresis, ozokerite applications, ultraviolet radiation. Antibiotics are prescribed only in case of suspected infection of the lesion.

Aseptic periostitis is treated with the use of physiotherapy. First of all, applications of permanent magnets are applied, which reduces the amount of exudate. And at the second stage, laser therapy or STP is used to dissolve thickenings and restore the structure of the periosteum.

With purulent periostitis, that is, resulting from infection, an operation is performed, during which the periosteum is dissected and pus is extracted outward.

The acute form of periostitis requires not only the use of surgery in the form of surgery, but also the appointment of antibiotics, drugs that remove intoxication, restorative medications and physiotherapy procedures.

In chronic periostitis appoint a course of medication of general strengthening nature, as well as antibiotics. In the treatment of this form of the disease, physiotherapy is shown that promotes the dissolution of pathological thickenings and growths on the bone - paraffin therapy, laser therapy, iontophoresis using 5% potassium iodide.

Preventive maintenance of a periostitis

Prevention of periostitis is the timely treatment of the causes that can lead to the onset of the disease.

For example, periostitis of the tooth or jaw can be prevented with timely treatment of dental caries, pulpitis and periodontitis. To do this, you need to visit the dentist for preventive purposes every three months. And if you find out the symptoms of a dental disease, immediately take care of their treatment.

Aseptic periostitis, which was caused by other diseases - tuberculosis, syphilis, osteomyelitis and so on, can be prevented by timely treatment of the underlying disease. It is necessary to take timely courses of drug treatment and physiotherapy. And also periodically undergo a diagnosis, which can reveal the appearance of periostitis at the earliest stage.

Traumatic and post-traumatic periostitis can be prevented by the immediately started treatment of periosteum tissue injuries - by physiotherapeutic and medicamentous procedures as prescribed by the doctor. In this case, the timely treatment of trauma is the main way to prevent periostitis.

With chronic periostitis, which occur unnoticed, without pronounced symptoms, it is necessary, first of all, to eliminate chronic inflammatory processes. It can be inflammatory diseases of various internal organs and systems, which must be subjected to timely therapy.

Prognosis of periostitis

The prognosis of recovery from periostitis depends on the form and type of the disease, as well as the timeliness of the treatment started.

Favorable forecasts concern traumatic and acute periostitis. If treatment is provided in a timely manner, the patient's condition improves, and then a complete recovery comes.

In purulent periostitis in advanced cases, if treatment is not timely, it is possible to predict an unfavorable prognosis of the course of the disease. In this case, complications occur - inflammation of all bone tissues appears and sepsis occurs.

Specific periostitis caused by various diseases, have a chronic form. Prognosis of recovery from chronic specific periostitis depends on the success of treatment of the underlying disease.

Periostitis is a rather insidious disease, which leads to serious consequences for the patient's organism and its bone system. Therefore, you should not hesitate with the treatment of periostitis, even with a minimal probability of inflammation of the periosteum.