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ABSTRACT Syphilis is a reemerging and potentially serious disease. Owing to its ubiquity and pleomorphism, it is called "the great imitator". We report the case of a young woman with secondary syphilis who presented with bilateral acute syphilitic posterior placoid chorioretinopathy along with a syphilitic skull periostitis. A pachymeningeal enhancement was observed on magnetic resonance imaging, but we believe it was an extension of the bone process rather than a meningitis itself on the basis of the normal cerebrospinal fluid analysis results. Treatment with intravenous crystalline penicillin resulted in complete resolution of the signs, symptoms, and imaging findings. Secondary syphilis is the stage with the highest bacteremia and the highest transmissibility, presenting mainly with mucocutaneous disorders and, less frequently, with involvement of other organs. High suspicion and a pragmatic approach are essential to the diagnosis because this disease can affect several organs, as in the present case, in which the eyes, bones, and skin were affected.
RESUMO A sífilis é uma doença reemergente e potencialmente grave. Por sua onipresença e pleomorfismo, é denominada "grande imitadora". Relatamos caso de paciente jovem com sífilis secundária, que se apresentou com coriorretinopatia placóide sifilítica posterior aguda bilateral, simultaneamente a periostite craniana sifilítica. A despeito de realce paquimeníngeo observado na ressonância magnética, acreditamos que este tenha sido uma extensão do processo ósseo e não, uma meningite em si, uma vez que o exame do líquido cefalorraquidiano estava completamente normal. Tratamento com penicilina cristalina intravenosa resultou em completa resolução dos sinais, sintomas e achados de imagem. A sífilis secundária é o estágio de maior bacteremia e maior transmissibilidade da doença, apresentando-se principalmente com quadros mucocutâneos, mas também, menos frequentemente, com envolvimento de outros órgãos. Elevada suspeição e uma abordagem pragmática são necessárias para o diagnóstico, uma vez que essa doença pode afetar vários órgãos, como no caso relatado, em que foram acometidos olhos, ossos e pele.
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Introdução: A periostite é uma inflamação do periósteo que pode se estender para os tecidos moles adjacentes. Há pouca informação na literatura sobre alterações genéticas nessas lesões, as quais são reparadas por intensas reações de proliferação osteoblástica e possuem curso clínico semelhante ao das osteomielites crônicas inespecíficas, que podem evoluir para neoplasias. Objetivo: análise citogenética de amostra de periostite para detecção e descrição de alterações cromossômicas, principalmente as associadas com desenvolvimento de neoplasias. Métodos: material obtido de lesão em palato de paciente, um homem de 74 anos de idade, submetido anteriormente a cirurgias de remoção de carcinoma basocelular em nariz e cavidade oral. Após a coleta, com estudo histopatológico confirmando apenas material de periostite, a amostra foi submetida à análise citogenética a partir de cultura de células e bandamento GTG. Resultados: o cariótipo composto evidenciou, como alterações clonais, monossomia dos cromossomos 10, 15, 20 e 22; trissomia do cromossomo 22; inversão do cromossomo 12 e deleção de 15q. O grande número de alterações cromossômicas estaria relacionado com a alta taxa de proliferação celular, a qual poderia induzir replicação celular desbalanceada e instabilidade genética. Há genes, envolvidos com desenvolvimento de neoplasias, localizados nos pontos de quebra das alterações estruturais encontradas nos cromossomos 12 e 15. Conclusão: foram evidenciadas várias alterações cromossômicas que refletiriam a proliferação celular local. A análise citogenética em casos de periostite poderá auxiliar na descoberta de biomarcadores de prognóstico e ser utilizada, futuramente, na rotina médica para um melhor manejo dos pacientes.
Introduction: Periostitis is an inflammation of the soft tissues adjacent to the bone that affects the periosteum. There is little information in the literature about genetic alterations in these lesions, which are repaired by intense osteoblast proliferation reactions and present a clinical course that resembles that of nonspecific chronic osteomyelitis that may progress to neoplasms. Objective: Cytogenetic analysis of periostitis sample for detection and description of chromosomal alterations, especially those associated with cancer development. Methods: Material obtained from a palate lesion of a 74-year-old man who had previously undergone surgery to remove basal cell carcinoma in the nose and oral cavity. After collection, with a histopathological study confirming only periostitis material, the sample was submitted to a cytogenetic analysis from cell culture and GTG banding. Results: The composite karyotype showed, as clonal alterations, monosomy of chromosomes 10, 15, 20, and 22; trisomy of chromosome 22; inversion of chromosome 12, and deletion of 15q. The large number of chromosomal alterations would be related to the high rate of cell proliferation, which could induce unbalanced cell replication and genetic instability. There are genes, which are involved in the development of neoplasms, mapped at the breakpoints of structural changes found on chromosomes 12 and 15. Conclusion: Several chromosomal alterations that were observed would reflect local cell proliferation. Cytogenetic analysis of periostitis may help in the discovery of prognostic biomarkers and may be used in the medical routine for better patient management in the future.
Subject(s)
Chromosome Aberrations , Periostitis , Cytogenetic AnalysisABSTRACT
Introduction@#The department of Maxillofacial surgery of the National Center for Maternal and Child Health (NCMCH) has a nationwide tertiary medical service for the children who is with congenital orofacial anomalies, facial injury, nonmalignant tumors of this area, and inflammations of maxillofacial area following odontogenic infection and other reasons as well. For the last years the number of the patients who are with odontogenic inflammation on the department has been growing constantly meaning that the necessity of medical care for our countries for children is also growing. Therefore by studying and analyzing the structure of the odontogenic inflammation and to determine the most frequent odontogenic inflammation among children in our country, to prevent them, define the treatment plan.@*Aim@#To clarify what kind of odontogenic maxillofacial inflammatory diseases mainly occurs among Mongolian children. @*Materials and Method@#We included all patients who are with odontogenic inflammation and underwent emergency and planned surgery in the department of Maxillofacial surgery, NCMCH between 2014-2018. </br> We used descriptive method based on the information of inpatients history record between 2014.01.01- 2018.12.31 at the department of Maxillofacial surgery, NCMCH and using our own –designed, prescreened survey card.</br> Statistical data processing is done using Microsoft Office-2019, SPSS for windows and STATA programs, and the results are shown illustrated method. The survey identified the incidence and frequency of each disease classification, and analyzed the characteristics of the child’s age, sex, and residency.@*Result @#In total 3533 children with odontogenic inflammation, whom age range is 0-18 years old, admitted at the department of Maxillofacial surgery for the surgical treatment were involved in this study.</br> Among which 1452(41.1%) male, 2081(58.9%) female. Considering the residency 2918(82.5%) children from Ulan-Bator and 615 (17.5%) children from countryside. The most of patients, who involved in this study were with odontogenic periostitis of maxillofacial area (67.5%), most were girls and preschool age (3-5 ages).@*Conclusion@#Based on the result of our study the most frequent inflammation was odontogenic periostitis of maxilla and mandible bone with 67.5%. The odontogenic phlegmon of orofacial area was the 2nd most frequent with 25.1%.</br> Inflammation of maxillofacial area was most frequent in 3-5 age group (preschool age) with 41.4%, and mostly in male. Considering the residency with 82.5% highest in Ulanbator.
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Abstract Florid reactive periostitis is a benign andrare lesion that is a recurrent diagnostic problem. Its etiopathogenesis remains unknown. Florid reactive periostitis consists of a fibrotic, cartilage- producing tumor accompanied by an aggressive inflammatory periosteal and soft tissue reaction. It typically occurs in adolescents and young adults, mostly female; it often affects hand and foot bones, and it may occur in long bones. Its diagnosis remains a major challenge due to the vast possibility of differential diagnoses. Therefore, careful clinical, radiological, and pathological evaluation is required to establish a proper diagnosis. We report the case of a patientwith florid reactive periostitis in the proximal phalanx of the right index finger, who underwent surgical excision with a wide margin, from the second ray to the proximal third of the secondmetacarpal bone, and evolved without complications,with satisfactory range of motion and strength.
Resumo A periostite reativa florida éumalesão benigna e rara que constitui umproblema recorrente de diagnóstico. Sua etiopatogênese permanece desconhecida. A periostite reativa florida caracteriza- se por ser uma reação periosteal agressiva e inflamatória de tecido mole e por ser um tumor portador de fibrose e produtor de cartilagem. Ocorreemadolescentes e adultos jovens, com predomínio no sexo feminino, e acomete com frequência os ossos das mãos e pés, podendoacometer tambémossos longos.Odiagnósticopermaneceumgrandedesafiodevido à enorme possibilidade de diagnósticos diferenciais. Por isso, uma cuidadosa avaliação clínica, radiológica e patológica é necessária para fechar o diagnóstico. Relata-se o caso de umpaciente com periostite reativa florida na falange proximal do segundo dedo da mão direita, que foi submetida à excisão cirúrgica com margem ampla do segundo raio até o terço proximal do segundometacarpo, e evoluiu semqueixas, comamplitude demovimento e força satisfatória.
Subject(s)
Humans , Female , Adolescent , Periostitis , Bone Neoplasms , Finger PhalangesABSTRACT
Introduction@#The department of Maxillofacial surgery of the National Center for Maternal and Child Health (NCMCH) has a nationwide tertiary medical service on the patients who is with congenital orofacial anomalies, facial injury, nonmalignant tumors of this area, and inflammations of maxillofacial area following dental caries and other reasons as well. For the last years nationwide the number of inpatient of the department has been growing constantly meaning that the necessity of medical care for our countries for children is also growing. Therefore by studying and analyzing the structure of the illness of the department will be able to determine the most frequent orofacial illness among children in our country, to prevent them, define the treatment plan.@*Aim@#To clarify what disease in the Maxillofacial area mainly occurs among Mongolian children. @*Materials and Method@#We included all patients who underwent emergency and planned surgery in the department of Max-illofacial surgery, NCMCH between 2014-2015. </br> We used descriptive and case-control method based on the information of inpatients history record between 2014.01.01-2015.01.01 at the department of Maxillofacial surgery, NCMCH and using our own –designed, pre-screened survey card. </br> Statistical data processing is done using Microsoft Office-2017 and SPSS for windows programs, and the results are shown illustrated method. The survey identified the incidence and frequency of each disease classification, and analyzed the characteristics of the child’s age, sex, and residency.@*Result@#The most of patients, who involved in this study were with the inflammation of maxillofacial area (57%), and the congenital orofacial clefts (24.4%). </br> In total 3300 children from 0-18 years old admitted at the department of Maxillofacial surgery and Infants study for orofacial surgery treatment were involved in this study. </br> Among which were 1803(54.6%) male, 1497(45.4%) female. Considering the residency, 2525(76.5%) children from Ulaanbaatar and 775 (23.5%) children from countryside. The most of patients, who involved in this study, were with the inflammation of maxillofacial area (57%), and the congenital orofacial clefts (24.4%).@*Conclusion@#Based on the result of our study the highest incidence among the participants was inflammation of maxillofacial area with 57% in which odontogenic periostitis was the most frequent with 21.6%. Congenital orofacial clefts and disorders was the 2<sup>nd</sup> most frequent with 24.4%. Inflammation of maxillo-facial area was most frequent in 0-2 age group with 33.7%, and mostly in male. Considering there were residency with 83.2% highest in Ulaanbaatar and mostly in Bayanzurkh district with 24.7%.
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ABSTRACT The authors report a case of congenital syphilis in a newborn with a bone lesion, resulting in left ankle periostitis.
RESUMO Os autores apresentam um caso de um recém-nascido portador de sífilis congênita com lesão óssea que evoluiu com periostite no tornozelo esquerdo.
Subject(s)
Pregnancy , Bone Diseases , Periostitis , Syphilis, CongenitalABSTRACT
Voriconazole is a broad spectrum triazole antifungal agent, widely used in the prevention and treatment of invasive fungal diseases.Long-term use of voriconazole can induce periostitis and cutaneous squamous cell carcinoma, accounting for serious adverse effects on patients, which has been reported in increasing clinical cases.This review is to characterize the epidemiological and clinical manifestations of periostitis and squamous cell carcinoma induced by voriconazole, and to analyze the mechanisms of triggering periostitis and squamous cell carcinoma, so as to promote the rational use of voriconazole in clinics.
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In prolonged chronic osteomyelitis, chronic inflammation and low-grade infections can result in new periosteal bone formation. Chronic osteomyelitis with proliferative periostitis (traditionally termed Garré's sclerosing osteomyelitis) mainly affects children and young adults. Here, we present two rare cases of an 11-year-old and a 12-year-old patient with suppurative chronic osteomyelitis with proliferative periostitis without any definitive infection source, such as dental caries or periodontitis. The source of infection was likely to be related to the development of a lower right third molar germ with follicular space widening. Management involved antibiotics and the removal of the third molar germ and surgical debridement. Disease remission and a normal appearance was observed at the six-month follow-up visit.
Subject(s)
Child , Humans , Young Adult , Aggressive Periodontitis , Anti-Bacterial Agents , Debridement , Dental Caries , Folliculitis , Follow-Up Studies , Inflammation , Molar, Third , Osteogenesis , Osteomyelitis , Periodontitis , PeriostitisABSTRACT
El síndrome de estrés tibial interno es una enfermedad frecuente en el personal militar durante los primeros meses de su entrenamiento. Su etiología no es muy clara y en diferentes trabajos se han descrito varios factores intrínsecos de riesgo relacionados con este síndrome, pero poco se han enfocado en identificar factores extrínsecos de riesgo en el personal militar. Objetivo: Hacer una aproximación a la identificación de los factores extrínsecos de riesgo relacionados con el síndrome de estrés tibial interno en personal militar de primer y segundo nivel de la Escuela Militar de Cadetes General José María Córdova. Metodología: La muestra la conformaron100 cadetes de la facultades de Educación Física Militar, de Ingeniería Civil y de Ciencias Militares, que contestaron dos cuestionarios: en uno se buscó identificar la presencia de síntomas y signos activos del síndrome de estrés tibial interno y, en el otro, los factores de riesgo descritos en la literatura y aquellos que a consideración del investigador podrían relacionarse con este síndrome. Resultados: El 21 % de los cadetes presentó el síndrome de estrés tibial interno. Los factores extrínsecos de riesgo identificados fueron: percibir el calzado deportivo de dotación como similar al calzado particular y realizar repetición de la actividad como correctivo en la formación militar. Los factores protectores identificados en los cadetes fueron: correr menos de 10 km, tener un acumulado de 20 a 30 km utilizando el calzado de dotación, percibir el calzado de dotación como pesado o similar al calzado común, desarrollar los entrenamientos físicos de su formación militar sobre la grama y realizar el correctivo militar trote alrededor de la escuela. Conclusion: Se logró determinar que considerar el calzado deportivo de dotación como inadecuado para el entrenamiento deportivo y someterse al correctivo militar...
Introduction: The medial tibial stress syndrome (MTES) is a common condition in military personnel during the first months of their training. Its etiology is unclear and different studies have described several intrinsic risk factors associated with this syndrome, but few have focused on identifying extrinsic risk factors in military personnel. Objective: The central aim of the study was to make an approach to the identification of extrinsic risk factors related to MTES in first year academy military personnel. Methodes: The sample consisted of 100 first year military personnel attending the physical education, civil engineering and military science pregraduate majors. They answered two questionnaires, one sought to identify cadets who had symptoms and signs of active MTES, and the second questionnaire sought to identify risk factors described in the literature and those that the researcher considered to be related to this syndrome. Results: 21% of the military personnel had MTES, and the extrinsic risk factors identified in the cadets were: perceiving the military issued sneakers as usual to the regular footwear and performing repetition of the activity as a corrective measure as part of the military training. Protective factors identified in the military personnel were: running less than 10 km, to have a total accumulated of 20 to 30 km using military issued boots, to perceive military issued footwear as heavy or usual to common footwear, to do the physical military training over grass and to run to the academy premises as a corrective measure in their military training. Conclusions: It was possible to identify that the military personnel who perceived as inadequate the military issued sneakers to perform their sports training and the military ...
Subject(s)
Risk Factors , Periostitis , Military Personnel , Medial Tibial Stress Syndrome , ColombiaABSTRACT
Psoriatic onycho-pachydermo-periostitis (POPP) causes severe nail dystrophy, painful soft tissue swelling, and marked periosteal reaction of the involved distal phalanx. There are few reports of POPP involving the great toe. We report on 2 cases of POPP involving the fingertips. A 60-year-old woman presented with fusiform swelling of her right 4th fingertip with severe tenderness, and her fingernails and toenails had varying degrees of onycholysis. She had mixed multiple erosions and meta-epiphyseal periostitis at the distal phalanx of the right 4th finger but was treated successfully with methotrexate and cyclosporine. A 39-year-old woman presented with painful swelling of the left 2nd and 5th fingertip, psoriatic lesions on the knees and soles of the feet, and onycholysis without reactive periostitis of the left 2nd and 5th fingers. She was treated successfully with cyclosporine. Despite its rarity, POPP should be considered when diagnosing arthritic or infectious conditions affecting the distal interphalangeal joint.
Subject(s)
Adult , Female , Humans , Middle Aged , Arthritis , Cyclosporine , Fingers , Foot , Joints , Knee , Methotrexate , Nails , Onycholysis , Periostitis , Psoriasis , ToesABSTRACT
Proliferative periostitis is a rare form of osteomyelitis that is characterized by new bone formation with periosteal reaction common causes of proliferative periostitis are dental caries, periodontitis, cysts, and trauma. While proliferative periostitis typically presents as a localized lesion, in this study, we describe an extensive form of proliferative periostitis involving the whole mandibular ramus and condyle. Because the radiographic findings were similar to osteogenic sarcoma, an accurate differential diagnosis was important for proper treatment.
Subject(s)
Dental Caries , Diagnosis, Differential , Mandibular Condyle , Osteogenesis , Osteomyelitis , Osteosarcoma , Periodontitis , PeriostitisABSTRACT
Numerous causes of hypertrophic osteoarthropathy (HOA) have been reported. Commonly, secondary osteoarthropathy accompanies pulmonary diseases such as carcinoma of the lung, pleural tumors, lung abscesses, and bronchiectasis. However, HOA in inflammatory bowel disease is a rare complication. There are only a few reports of secondary HOA with Crohn's disease. Our purpose was to report another case of HOA in Crohn's disease. We describe a case of a 27-year-old man with underlying Crohn's disease presenting with 2 years of pain in multiple joints. Radiographic findings suggested HOA in extremities. We performed a conservative treatment including medication and rehabilitations. The patient's symptoms were much improved at the latest follow-up. Although numerous studies on HOA have been published, the pathogenesis of HOA is still unclear. Various treatment modalities were recommended but further studies to uncover the pathogenesis of HOA with Crohn's disease and to establish a treatment modality are needed.
Subject(s)
Adult , Humans , Bronchiectasis , Crohn Disease , Extremities , Follow-Up Studies , Inflammatory Bowel Diseases , Joints , Lung , Lung Abscess , Lung Diseases , PeriostitisABSTRACT
La osteomielitis crónica con periostitis proliferativa es un tipo de alteración caracterizada por una reacción periosteal exacerbada causada por un estimulo de baja intensidad, generalmente una lesión cariosa con patología periapical asociada. Actúa principalmente en niños y adolescentes con predilección por la región basilar de mandíbula. Clínicamente, se manifiesta a través de un aumento de volumen doloroso intra o extraoral, de consistencia endurecida. Radiográficamente presenta laminas óseas neoformadas, paralelas entre si con superficie cortical, observándose el aspecto típico de "cascara de cebolla". El tratamiento incluye el retiro del factor etiológico con o sin antibioterapia y posterior restablecimiento de la simetría facial del paciente. Este trabajo presenta un caso de osteomielitis crónica con periostitis proliferativa en una paciente de sexo femenino de 11 años de edad, causada por una lesión cariosa en el primer molar inferior izquierdo, quien fue sometida a exodoncia del diente comprometido con posterior restablecimiento de la simetría facial.
Chronic osteomyelitis with proliferative periostitis is a kind of osteomyelitis that is characterized by a great periosteal reaction resulting of low grade stimulation, usually a caries lesion associated a periapical pathology. It affects especially children and young adults, with the mandible as the most common site, usually in the inferior aspect. Clinically presents as a painless hard swelling intra and/or extra-oral. Radiographic aspects include bone layers new formed, parallel to each other and to the underlying cortical surface, giving the characteristic appearance of "onion skin". Treatment includes elimination of the cause, with or without antibiotics, being restored the facial symmetry of patient. The present article is a clinical case report of chronic osteomyelitis with proliferative periostitis affecting a female 11 year old patient, caused by a caries lesion in the left permanent first molar, that was submissed to a exodontia and the facial symmetry of the patient was restored with management.
Subject(s)
Humans , Female , Child , Dental Caries/surgery , Dental Caries/complications , Osteomyelitis/etiology , Periostitis/etiology , Chronic Disease , Surgery, OralABSTRACT
Periostitis is one of the human diseases commonly encountered in archaeological samples. It is known to be an important health indicator for paleopathologists examining skeletal remains. In our recent study on a Joseon skeletal series (n=101), non-specific, primary periostitis was observed only in five individuals (#4, #29, #137, #175, and #290). Notably, there were no secondary periostitis-suggestive signs (e.g. syphilis), except for those caused by fractures (#33 and #41). As this is the inaugural Korean-skeletal-series report on periostitis, the results presented in these pages should prove significant to interested paleopathologists.
Subject(s)
Humans , Paleopathology , Periostitis , Skeleton , SyphilisABSTRACT
O objetivo deste ensaio iconográfico é estimular a avaliação cuidadosa das reações periosteais nas imagens de ressonância magnética. A abordagem inicial das lesões ósseas é realizada por meio das radiografias simples e pela avaliação destas se faz a classificação das reações periosteais em subtipos clássicos. Embora a ressonância magnética seja considerada o padrão ouro para o estadiamento regional das neoplasias ósseas, seu uso no estudo das reações periosteais relacionadas às lesões ósseas focais tem sido relativamente pouco enfatizado. A revisão da literatura evidencia um modelo experimental animal de osteomielite que sugere que a ressonância magnética seja superior às outras técnicas de imagem na identificação precoce das reações periosteais. Outro estudo encontrado na literatura sugere boa correlação entre as radiografias simples e as imagens de ressonância magnética na identificação e na classificação das reações periosteais no osteossarcoma. Neste ensaio foram ilustrados casos de reações periosteais observadas pela ressonância magnética, correlacionado-as com as radiografias convencionais ou com outros métodos de diagnóstico por imagem.
The objective of the present essay was to encourage a careful evaluation of periosteal reactions on magnetic resonance images. The initial approach to bone lesions is made by conventional radiography and, based on the imaging findings, periosteal reactions are classified into classical subtypes. Although magnetic resonance imaging is considered as the gold standard for local staging of bone tumors, the utilization of such method in the study of periosteal reactions related to focal bone lesions has been poorly emphasized, with relatively few studies approaching this subject. The literature review revealed a study describing an experimental animal model of osteomyelitis suggesting that magnetic resonance imaging is superior to other imaging methods in the early identification of periosteal reactions. Another study has suggested a good correlation between conventional radiography and magnetic resonance imaging in the identification and classification of periosteal reactions in cases of osteosarcoma. The present essay illustrates cases of periosteal reactions observed at magnetic resonance imaging in correlation with findings of conventional radiography or other imaging methods.
Subject(s)
Animals , Rabbits , Bone Neoplasms/diagnosis , Bone Neoplasms , Periostitis , Periostitis/chemically induced , Diagnostic Imaging , Magnetic Resonance ImagingABSTRACT
Introdução: a sífilis causa morbidade na vida intrauterina, desfechos negativos em mais de 50% dos casos e complicações nos nascidos vivos. Lesões ósseas são frequentes na sífilis congênita (SC), ocorrendo em 70 a 100% dos casos. Objetivo: relatar casos de dez lactentes com diagnóstico de SC precoce e alterações ósseas ao exame radiológico de ossos longos, acompanhados no Serviço de Infectologia do HINSG. Relato dos casos: dez lactentes apresentaram lesões ósseas, entre crianças internadas com SC no HINSG, seis do sexo feminino e quatro do masculino. Metade era proveniente da Grande Vitória, três do interior e dois da Bahia. Dois tinham menos de 1 mês de vida. Seis das mães fizeram pré-natal, três tiveram o diagnóstico de sífilis na gestação e apenas uma foi adequadamente tratada. Duas crianças apresentaram osteomielite, sendo uma com lesão lítica na tíbia e as demais tiveram periostite. Mais de um osso foi afetado em seis lactentes. Os ossos mais afetados foram: tíbia (7/10), fêmur (6/10), úmero (5/10), rádio (2/10) e ulna (2/10). Sintoma comum entre todos foi choro frequente ao movimento de membros superiores ou inferiores, motivo de as mães terem procurado o serviço médico. Discussão: alterações radiológicas são importantes no diagnóstico de SC. Neste estudo, 60% das mães fizeram pré-natal, uma foi tratada corretamente e nenhuma das crianças foi diagnosticada e tratada logo após o nascimento, somente recebendo medicação adequada após o diagnóstico no nosso serviço. Alterações radiológicas da SC podem acontecer em tempo variado após a instalação da infecção. Podem ocorrer diferentes lesões, que incluem lesões da SC precoce: osteomielite diafisária, osteítes e periostite. Osteocondrite afeta áreas da cartilagem em crescimento. Lesões da SC tardia são severas, podem causar deformidades físicas e fratura patológica na criança, necrose de osso e osteólise no adulto e, às vezes associam-se a infecção piogênica ou difusão para tecidos adjacentes, com formações de fístulas cutâneas indolores.
Introduction: syphilis morbidity in intra-uterine life, produces negative outcomes in more than 50% of cases and complications in live births. Bone injuries are frequent in congenital syphilis (CS), occurring in 70 to 100% of the cases. Objective: to report cases of ten infants diagnosed with early SC and bone changes to the radiological examination of long bones, accompanied in the infectology service of HINSG. Case report: ten infants had bone injuries among children hospitalized with CS in HINSG, six female and four male. Half of the metropolitan region of Vitória, two from the interior and three from state of Bahia. Two were less than a month old. Six of the mothers had prenatal care, three were diagnosed with syphilis during pregnancy and only one was properly treated. Two children had osteomyelitis, and with a lytic lesion in the tibia and the other had periostitis. More than one bone was affected in six infants. Bones most affected: tibia (7/10), femur (6/10), humerus (5/10), radio (2/10) and ulna (2/10). Common symptom among all were frequent crying with movement of members. Reason why mothers have sought medical service. Discussion: changes are important in radiological diagnosis of CS. In thisstudy 60% of mothers have prenatal care, one was treated correctly and none of the children were diagnosed and treated soon after birth, only receiving proper medication after diagnosis in our service. Radiological changes of CS may happen after installation according to time of infection. Various injuries may occur, including injuries of CS early: osteomyelitis diaphyseal, osteítes and periostitis. Osteochondritis affects cartilage in areas of growth. Injury of late CS are severe, can cause physical de formities and pathological fracture in children, necrosis of bone and osteolysis in adults and sometimes linking up with pyogenic infection or spread to adjacent tissues, with formation of fistulas skin painless.
Subject(s)
Humans , Male , Female , Infant , Periostitis/radiotherapy , Syphilis, Congenital , Bone Diseases, Infectious , Sexually Transmitted DiseasesABSTRACT
Proliferative periostitis is a disease characterized for successive deposition of layers of subperiosteal bone as a response reaction to a chronic inflammatory stimulation. The affected periosteum forms several rows of reactive bone that are parallel and expand the surface of the altered bone. Dens in dente is a developmental malformation resulting from invagination of the crown before calcification has occurred. They are usually diagnosed upon routine clinical and radiographic examination. An unusual case report of a mandibular dens in dente causing proliferative periostitis is presented. The source of infection was related to dens in dente in mandibular left second premolar's crown, which had apparently communication with periodontal tissues. It was successfully treated by surgical therapy with antibiotic duringthe treatment. After the extraction of the affected tooth, radiographic follow-up showed the decrease of proliferative periostitis, and remodelation of the cortical bone.
A periostite proliferativa é uma doença caracterizada por sucessivas deposições de camadas de osso subperióstica como resposta a um estímulo crônico inflamatório. O periósteo afetado forma sucessivas camadas de osso reacional paralelas entre si e expandem a superfície óssea nesse local. Dens in dente é uma alteração do desenvolvimento resultante de invaginação de esmalte para a dentina antes de sua calcificação ocorrer. Usualmente são diagnosticadas em exames clínicos-radiográficos de rotina. Um relato de caso clínico raro é apresentado sobre dens in dente na coroa do segundo pré-molar inferior causando periostite proliferativa. A fonte de infecção foi o dens in dente que tinha comunicação do meio bucal com a área do periodonto. Foi realizada a extração do dente anômalo associado com uso de antibióticos. As radiografias de controle mostraram diminuição da periostite proliferativa como remodelamento do osso cortical.
Subject(s)
Humans , Male , Child , Dens in Dente , Dental Pulp Necrosis , Osteomyelitis , Periostitis/complications , Periostitis/diagnosis , Periostitis , PeriosteumABSTRACT
We describe the case of a 4-month-old male infant diagnosed with early congenital syphilis during evaluation of a left distal humerus fracture. This report emphasizes the importance of screening for syphilis among pregnant women and newborns, and is a reminder of the continued existence of congenital syphilis.
Subject(s)
Child , Female , Humans , Infant , Infant, Newborn , Male , Child Abuse , Humerus , Mass Screening , Periostitis , Pregnant Women , Syphilis , Syphilis, CongenitalABSTRACT
To observe the clinical effect of oblique puncture plus plucking manual technique for fatigue periositis of tibia.Methods:60 cases of the patients with fatigue Deriostitisof tibia were randomly divided into the treatment group of 30 cases treated by oblique puncture plus plucking manual technique,and the control group of 30 cases treated by ultra short wave.Resuits:The curative rate was 60.0% in the treatment group and 20.0% in the control group.and the total effective rate was 93.3% and 70.O% respectively.The therapeutic effect was better in the treatment group than in the control group (P＜0.05).Conclusion:Oblique puncture plus plucking manual technique has a better therapeutic effect for fatigue periostitis of tibia.
ABSTRACT
Hyaline ring granuloma (HRG) is a comparatively rare inflammatory condition occurring mainly in the oral region, and is characterized by hyaline rings (HRs) formed in the granulation tissue. This study describes a case of HRG occurring in the mandibular periosteum of an 18-year-old male. Histopathologic, histochemical and electron microscopic studies were performed on surgically excised materials. Histopathologically, ovoid bodies (OBs) surrounded by thin hyaline walls and HRs showing pale-stained eosinophilic thick hyaline walls were both detected. Histochemical study revealed that the OBs contained many granules chiefly composed of starch. Ultrastructurally, the HRs presented a stratiform structure due to the accumulation of cross-banded collagen fibrils with a basement membrane-like lining containing cellulose microfilaments. These results suggest that HRs are formed as follows: the exogenous vegetable materials are encapsulated by collagen, then the component is gradually degraded; the residual cellulose fraction adheres to the inner surface of the collagenous capsules, and the continuous deposition of collagen at the outer surface of the capsules increases its thickness. Finally, thick hyaline walls of HRs are formed. The possible pathogenesis of this curious lesion is discussed for stomatologists.