Bone diseases Flashcards
Garre’s sclerosing osteomyelitis is also called:
1.Proliferative periostitis
2.Osteomyelitis with proliferative periostitis
3.Periostitis ossificans
Histopathologic picture of proliferative periostitis
1.Trabeculae of woven bone: arranged in parallel rows or retiform (interconnecting meshwork), often perpendicular to the surface.
2.Intertrabecular loose, vascular, uninflammed fibrous connective tissue.
Proliferative periostitis
Histopathologic picture includes:
1.Trabeculae of woven bone: arranged in parallel rows or retiform (interconnecting meshwork), often perpendicular to the surface.
2.Intertrabecular loose, vascular, uninflammed fibrous connective tissue.
Proliferative periostitis
Histopathologic picture includes:
1.Trabeculae of woven bone: arranged in parallel rows or retiform (interconnecting meshwork), often perpendicular to the surface.
2.Intertrabecular loose, vascular, uninflammed fibrous connective tissue.
Proliferative periostitis
Histopathologic picture includes:
1.Trabeculae of woven bone: arranged in parallel rows or retiform (interconnecting meshwork), often perpendicular to the surface.
2.Intertrabecular loose, vascular, uninflammed fibrous connective tissue.
Proliferative periostitis
Histopathologic picture includes:
1.Trabeculae of woven bone: arranged in parallel rows or retiform (interconnecting meshwork), often perpendicular to the surface.
2.Intertrabecular loose, vascular, uninflammed fibrous connective tissue.
Proliferative periostitis - differential diagnosis
1.Osteogenic sarcoma
2.Ewing sarcoma
3.Langerhans cell histiocytosis
4.Ossifying fibroma
Proliferative periostitis - Age
Children and young adults.
Average age: 13
Proliferative periostitis - clinical presentation
Non-painful swelling
Unilateral
Usually in the posterior mandible
Hard consistency
Proliferative periostitis - radiographic picture
Focal parallel radiopacities extending from the cortical surface
“Onion skin” appearance
Radiolucent area between original cortex and the newly formed bone layers
Proliferative periostitis - locations frequencies
- Inferior border of mandible
- Buccal cortex of mandible
- Lingual cortex of mandible
Proliferative periostitis - number of bony layers
1-12
Proliferative periostitis etiology
Reactive lesion:
1. Periapical inflammation
2. Periodontal inflammation
3. Buccal bifurcation cyst
Proliferative periostitis - time of bone remodeling
6-12 months after removal of cause (e.g. RCT)
Primary chronic ostemyelitis (PCO) and diffuse sclerosing osteomyelitis (DSO): what is the etiology difference?
PCO: no association with dental infection; probably immunologic etiology.
DSO: associated with chronic dental infection.
Primary chronic ostemyelitis (PCO) and diffuse sclerosing osteomyelitis (DSO): what is the difference in the clinical presentation?
PCO: pain, swelling
DSO: no pain and swelling
PCO: clinical picture
Pain
Swelling (bone expansion) Facial deformity
Trismus
Lymphadenopathy
Loss of sensation
The nature of the disease is cylic: periodic episodes of flares and remissions
Primary chronic osteomyelitis and chronic suppurative osteomyelitis: what are the differences in the clinical presentation?
PCO:
NO fever
NO pus discharge
NO fistula formation
NO sequestration of bone
CSO: the above signs are present.
Primary chronic ostemyelitis (PCO) and diffuse sclerosing osteomyelitis (DSO): what is the difference in the radiographic presentation?
PCO:
radiographic features can include the following:
1.RL lesion (osteolysis)
2.Mixed RL-RO lesion
3.RO lesion (osteosclerosis)
4.Periosteal thickening
5.External bone resorption
DSO:
Diffuse radiopacity
Primary chronic ostemyelitis (PCO): therapeutic management
Medication:
Biphosphanates
NSAIDs
Corticosteroids
Pamidronate
Denosumab
Calcitonin
Tumor necrosis factor-a antagonists
Hyperbaric oxygen
Decortication
Chronic sclerosing osteomyelitis: therapeutic management
Treatment of removal of infected tooth
What is CRMO?
Chronic Recurrent Multifocal Osteomyelitis
Shows PCO in extra-gnathic bones
What is SAPHO?
Sinovitis, Acne, Putulosis, Hyperostosis, Osteitis
Shows PCO in extra-gnathic bones
Chronic tendoperiostitis
A variant of PCO, where parafunctional, overuse of masticatory muscles exist
