From Big Medical Encyclopedia

OSTEOPERIOSTITIS (osteoperiostitis; grech, osteon a bone a periostitis) — inflammatory process in a bone with preferential damage of a periosteum; mainly radiologists for designation of a certain radiological symptom complex since clinically O. is more often shown use the term «osteoperiostitis» and flows as osteomyelitis.

Various representatives of purulent and specific microflora can be activators O. Therefore it meets at hematogenous and posttraumatic osteomyelitis (see), bone tuberculosis (see. Tuberculosis extra pulmonary, tuberculosis of bones and joints ), syphilis (see), sclerosing osteomyelitis of Garre, Brodie's abscesses (see. Brody abscess ), gonorrheal, brucellous, typroid and other inflammatory processes in bones. Actinomycotic

O. O. cases are described arises owing to transition of process from soft tissues to a bone that more often happens at posttraumatic osteomyelitis, or, on the contrary, having begun in marrow, the inflammation extends to a periosteum. Severe forms of O. are observed after the infected open changes and nearthroses.

Gistol, and bacterial, a research confirms infectious and inflammatory genesis of a disease. Already at limited O. there is amotio of a periosteum that breaks communication of a bone with soft tissues and worsens a trophicity of the affected bone, promoting formation of sequesters (see. Sequester, sequestration ).

Rentgenol, recognition of O. arising at various inflammatory diseases or traumatic injuries of a bone is based on detection and studying of the destructions of bone substance and reparative changes happening at this process. The destructive phenomena belong generally to cortical substance of a bone, reparative — is preferential to a periosteum and to a lesser extent to an endosteum. Destruction of bone substance at undoubted clinical and anatomic signs of inflammatory process radiological is found only at sufficient extent of development of this process, and reparative changes — only at calcification of the ossiform substance formed by a periosteum.

Fig. 1. Direct roentgenograms of bones of a shin (a) and femur (b) of the patient» with an osteoperiostitis: and — ossifitsirovanny periosteal imposings (are specified by an arrow) on the interior of a tibial bone are separated from a surface of a bast layer by a thin strip of an enlightenment; — cortical abscess, the destructive center (it is specified by an arrow) in the depth of a reinforced bast layer of a bone.

Nonspecific O.'s picture of long tubular bones is most indicative rentgenol. In the beginning there is a strip of a shadow of calciphied periosteal imposings accompanying cortical substance separated from an outer surface of cortical substance of a bone by a thin coat not calciphied patol, fabrics. Between periosteal calciphied imposings and cortical substance there is a strip, transparent for X-ray (fig. 1, a). In process of development patol. process calciphied masses, being gradually thickened, merge with the subject bone. The periosteal imposings which merged with compact substance create a picture of an asymmetric thickening of a bone. In the depth of this thickening the center of destruction of various sizes (fig. 1, b) which is the center of all patholologically of the changed site of a bone is visible; sometimes in the center of destructive focus it is possible to find the small bone sequester. The convex surface of a bone of a knaruzha in the place of a thickening has smooth or rough outlines. At cortical abscess the destructive center is defined.

Fig. 2. Roentgenogram of an elbow joint of the patient with a gummous osteoperiostitis: regional destructive defect of an ulna (ukazanstrelky).

At gummous O. rentgenol, the picture differs in a bit different sequence of changes. Periosteal imposings are Ossy-fitsirovannye a consequence of development of microscopic perivascular infiltrates in a periosteum therefore macroscopically audible destruction of bone substance usually is absent in the beginning. Destruction comes to light, as a rule, later when there is a disintegration of again formed bone substance because of property inherent in gummous process obligatory to pass this stage of chronic inflammatory process. The destructive center arising at the same time usually has an appearance of regional defect (fig. 2). In hard cases at differential diagnosis of gummous O. with cortical abscess existence of the cortical sequester even at regional destructive defect speaks well nonspecific, but not syphilitic

O. Klien, the picture O. is defined by character of the basic disease which served as the reason of development of the Lake. The same treats also treatment, prevention, O.'s forecast (see. Brody abscess ; Osteomyelitis , Periostitis ; Syphilis ; Tuberculosis extra pulmonary, tuberculosis of bones and joints ).

See also Bone (pathology) .

Bibliography: Popkirov S. Gnoynosepticheskaya surgery, the lane with bolg., Sofia, 1977; Reynberg S.A. Radiodiagnosis of diseases of bones and joints, book 1 — 2, M., 1964.

O. N. Markova; S. A. Sviridov (rents.).