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Periostitis, what is it? Types, treatment and complications

What it is?

Periostitis is the process of inflammation of the periosteum (a structure of connective tissue that completely envelops the bone). The inflammatory process begins on the surface of the periosteum and then spreads inward. Bone tissue is also susceptible to inflammation, and if untreated, the disease can smoothly turn into osteoperiostitis.

The code that refers to periostitis in µb 10: C10.2. The disease is localized in different parts of the body and has several forms: acute, purulent, chronic and multiple. Symptoms and manifestations differ depending on the site of inflammation of the periosteum.

Causes of periostitis have a different nature:

  • Consequences of injuries associated with bones and tendons: sprains, ruptures, fractures of any type, joint dislocations;
  • The spread of inflammation from a number of tissues: mucous, skin, joint tissues;
  • Local toxic infection of the periosteum or intoxication of the whole organism;
  • Local effects of allergens on connective tissue;
  • Rheumatic diseases;
  • The consequences of tuberculosis , syphilis , actinomycosis, and so on.

Content

Types of periostitis and localization

Periostitis legs

photo scheme

Periostitis may manifest itself in different ways, depending on the type and location of inflammation, and is classified into four varieties:

  1. Aseptic - swelling without clear edges, characterized by very painful sensations when pressed, the temperature at the site of inflammation increases. If the leg bones are affected, then limping is observed. However, the main difference of this form is that the cause is not a microbial agent. Most often this is an allergic reaction from the periosteum or its damage in diffuse pathologies of connective tissue.
  2. Fibrous - swelling is outlined, but the patient has no pain, even when touched. The inflammation itself is dense, and the mucous membrane or skin above it is mobile. The basis of this condition is the pathological proliferation of collagen in response to an inflammatory response.
  3. Ossifitsiruyuschee - swelling is very sharply outlined and characterized by a solid, heterogeneous, uneven consistency. In response to inflammation, an abnormal bone tissue grows.
  4. Purulent - swelling is very painful, there is swelling in the surrounding tissues. The body temperature rises, the patient feels unwell, depressed and depressed, quickly gets tired. In this form, intoxication is very pronounced, since it is caused by pyogenic (pyogenic) bacteria.

Periostitis of the jaw (tooth)

Periostitis of the jaw

In the oral cavity is often observed acute purulent periostitis of the jaw, which is caused by jaw bone injuries due to teething, dental treatment, infection. Also, the cause of the disease can be periodontitis and periodontal disease. The catalyst for inflammation can be stressful situations, hypothermia, fatigue and reduced immunity.

Acute periostitis involves a plentiful excretion of purulent masses from the source of inflammation; therefore, swelling forms in the periosteum. Initially, the pain is not very pronounced, but after 1-3 days the pain increases and spreads to the entire jaw, gives to the temple, eyes, ear.

The area around the tooth itself may not be sensitive to pain. Due to the active inflammatory process, there is an increase in temperature up to 39 degrees.

The tissue of the periosteum is loosened, swelling increases, a serous substance (exudate) is formed in the inflammatory cavities, which soon turns into purulent. Thus, an abscess is formed, and pus in severe cases can penetrate under the periosteum, causing more serious pathological changes.

Otherwise, an abscess can find a way out on its own or destroy a dental crown, roots and fillings of a tooth. The patient is difficult to eat because of the increased pain reaction in the process of chewing.

If the periostitis of the upper jaw is diagnosed, the edema is localized in the region of the upper lip, the wings of the nose, in rare cases on the eyelids. With inflammation of the molars and premolars, the edema enters the cheek area, there is puffiness of the face and the “swimming” of the cheekbones.

The periostitis of the lower jaw is characterized by swelling of the lower part of the face: the outlines of the chin are lost, the area above the Adamicum swells, the corners of the lips go down, the lower lip increases and also descends. With this kind of disease, chewing food is especially hard, because the swelling extends to the medial and chewing muscles. Lymph nodes increase, in severe cases, adhesions are formed.

An abscess from the palate and gums can go to the surface of the tongue, then there is a through inflammation in which pus accumulates. In rare cases, the patient has periostitis of the salivary glands encircling the lower jaw.

The presence of cysts by the saliva content of yellowish thick impurities is determined. Acute periostitis is characterized by the appearance of purulent substances within 3-4 days after inflammation.

Periostitis legs

Periostitis legs

Periostitis of the bones on the legs, as a rule, is especially common in athletes whose activity is associated with active running. Systematic non-severe injuries: sprains, mild dislocations, bruises, leads to seals in the bone tissue.

  • The most common diagnosis is considered tibial periostitis, which is most susceptible to various loads during physical training.

The periosteum of the tibia bones is very sensitive, since highly innervated. With the development of the disease, the pain is localized in the upper part of the leg, with palpation increases. Discomfort caused by inflammation and the formation of swelling. Diagnosis of periostitis is possible not earlier than one month after the beginning of the formation of an abscess (localized accumulation of pus).

If the joint bag in the knee was injured, osteoperiosteitis develops - swelling appears directly on the bone. The periostitis of the joint provokes pains during movement or even difficulty in walking.

The tissues surrounding the compaction swell and block the functionality of the knee joint, so the patient is shown surgical removal of the purulent focus.

Periostitis of the foot also appears due to injuries, incl. and microtrauma when wearing uncomfortable shoes. Anything that can squeeze, rub, or overload a bone can lead to inflammation of the periosteum. Due to edema, the foot is deformed, the abscess causes very painful sensations, so normal walking is difficult or impossible. Compensatory claudication appears, i.e. patient spares a sore foot.

Periostitis of the nose

Such a disease occurs after systematic nasal bridge injuries; wrestling athletes are often susceptible to it. There is a possibility of an abscess also after long-term inflammatory processes in the sinuses.

The disease is diagnosed almost immediately, because pain syndromes during palpation of swelling in the nose cannot be caused by anything other than suppuration (in mild cases it is a furuncle, and in severe cases it is periostitis).

  • There is a deformation of the nose - external in the form of humps or internal, blocking the passage of the nostrils.

Periostitis eyes

This is inflammation in the periosteum of the orbit, which occurs only due to infection by pathogenic cocci microorganisms. The skin around the orbit swells, there is pain when touching. The disease in this area develops more slowly than in the rest - often takes from 3 weeks to 2 months.

The periostitis of the eye is dangerous by the direct connection of the orbit with the brain (through the passing nerves and vessels).

Ocular periostitis may be secondary in acute diseases of the nasopharynx and throat: sore throat, SARS, measles , scarlet fever , influenza. The appearance of edema can also be due to severe periostitis in the mouth and sinuses. The periosteum coalesces with the bone, forming a dense callus.

If this process is not stopped, the pus will get inside the bone and the tissue will exfoliate, which affects the duration and type of treatment.

Periostitis in a child

Periostitis in a child

Periostitis in children can not take a chronic form and develops mainly in the mouth. The disease is caused by the growth and change of teeth, the catalyst is infection due to insufficient level of children's hygiene.

In order to reduce the risks, the child must be weaned from the habit of taking in his hands and other objects that have been seeded with bacteria. In rare cases, the disease occurs due to incorrect actions of the dentist.

When periostitis in children, the lymph nodes are inflamed, since the immune system has not yet had time to get stronger. However, do not confuse bone disease with a cold because of the similarity of symptoms.

Treatment of periostitis, drugs

A timely visit to a doctor for periostitis is considered to be 2-5 days after the onset of inflammation. The specialist conducts a visual inspection of the abscess, and a complete blood count is assigned. After that, the patient is shown a radical intervention - the opening of a purulent focus and his cleansing.

If the swelling is localized on the mucous membrane, the surgeon will make a small incision under local injection anesthesia, the procedure itself will take 20-45 minutes.

Treatment of periostitis in the mouth may require the removal of the tooth, around which there is inflammation. This decision is made by the doctor, depending on each specific case, more likely to preserve the front teeth with one root process. Opening the canal and cleaning the root must be performed.

For successful treatment of bone periostitis, the therapy should be comprehensive - after surgery, the patient is prescribed antiseptic, anti-inflammatory, antihistamine drugs, as well as antibiotics and analgesics. To support the body's immune response, vitamins and calcium-containing agents are indicated.

  • Surgical intervention in the articular tissue is rarely performed.

The first stage of treatment of periostitis in the limbs is a set of physical exercises or massages. To overstrain and develop problematic joints through pain is strictly forbidden so as not to cause aggravation of the pathological process.

To avoid surgery, patients are recommended warming bandages and gels. Medications are prescribed that are aimed at suppressing inflammation - these are drugs Lornoxicam, Sulfadimizin, Sulfadimethoxin.

Physiotherapy after surgery includes warm baths or rinsing with antiseptic solutions. It is recommended to undergo UHF and microwave therapy and treat the place with healing ointments: Levomikol, Levomizol, camphor oil, sea buckthorn and rosehip.

  • 3-4 days after the dissection, the inflammation should noticeably subside, and the pain should disappear.

If a positive effect is not observed, the patient is shown additional infiltration of the abscess focus. The more severe the case, the wider the range of antibiotics involved in the treatment of periostitis, in such cases hospitalization and daily injections are necessary during the week.

Complications

Purulent inflammatory processes affect the general condition of the body - manifestations are characteristic in the form of a prolonged increase in the size of the lymph nodes, intoxication, exhaustion. Problems with food intake and constant pain affect the patient's morale, apathy, depression, dissatisfaction, and emotional overstrain are possible.

Fistulous canals can become a complication of periostitis of the oral cavity - this happens if the patient has strongly delayed a visit to the doctor. This is due to the fact that purulent masses have nowhere to go, and they "are looking for another way out."

Fistula treatment requires more complex surgery and increases the duration of rehabilitation.

If you run periostitis strongly, the bone will be subject to deep destruction (destruction). Due to the penetration of the abscess inside the periosteum, and then into the bone tissue, it begins to lysing and thinning. There is bone dystrophy, which interferes with the normal functioning of the musculoskeletal system.

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