Periosteum inflammation – causes, symptoms & therapy

The inflammation of the periosteum is also known as periostitis, with the syllable periosteum standing for the bone. The suffix -itis indicates inflammation. In this context, only the periosteum is involved in periosteum inflammation. The periosteum is a thin layer of tissue (connective tissue cover) that covers all the bones of the human skeleton. Periostitis is therefore an inflammation of this connective tissue envelope.

In the case of periosteum inflammation, there are different manifestations. These form the basis for distinguishing between purulent and acute periosteum inflammation. Periosteum inflammation can occur in both children and adults and can be detected using very specific diagnostic techniques.

causes

In addition to internal triggers, external triggers can also be considered when identifying the cause of periosteum inflammation. There are known connections between the onset of periosteum inflammation and microbial germs as well as excessive and incorrect stress on the bones. Microbial causes of periosteum inflammation are mainly represented by Staphylococcus aureus.In addition, so-called streptococci or other pus-producing strains of bacteria can also be considered. Not only the bacteria , but also other microorganisms such as viruses can be a cause of periosteum inflammation.

Acute periostitis or inflammation of the periosteum can also be caused by mechanical influences. In this context, in addition to incorrect loading, local overloading of the bone usually comes into consideration.

When to the doctor?

In particular, inflammation of the periosteum as a result of sporting overload can result in a lengthy healing process if the therapy is inconsistent (breaks from exercise are too short). Depending on the success of the therapy, complete healing can take a few weeks or months. For this reason, a doctor should be consulted in the early stages.

Periostitis typically manifests itself through pressure and stress pain. In addition, redness and swelling of the affected region are not uncommon. Under certain circumstances, inflammation of the periosteum can also be accompanied by fever and a general feeling of illness. Insomnia can also occur due to persistent pain.

A doctor should be consulted at the latest when the symptoms lead to significant limitations in everyday life (e.g. restricted movement) and thus impair the patient’s quality of life.

symptoms and course

Possible symptoms of periosteum inflammation:

• Pain in the affected body region

• Shin splints as a typical symptom of overuse in athletes (jogging)

• Typical signs of inflammation (swelling, redness, warmth)

• general feeling of illness

• discharge of pus

Periosteum inflammation is characterized by the typical signs of inflammation that initially appear, which basically consist of local redness, swelling, heat and pain in the affected region. For this reason, at the beginning of periosteum inflammation, swelling occurs in the specific areas. A minimal redness and of course the intense and quite stubborn pain accompany the patients during the periosteum inflammation.

In the case of a purulent inflammation of the periosteum, very special symptoms appear. Acute bone inflammation is reflected in severe malaise and a reduction in general condition. The pain is localized and very severe. In the case of a purulent inflammation of the periosteum, purulent discharge can occur due to what is known as a fistula.

Diagnose

The conversation with the patient alone can sometimes bring the first indications that the patient is affected by periosteum inflammation. In order for the periosteum to be diagnosed, the doctor examines the body for any symptoms that are classic for the disease. These are sometimes thickenings or water retention. When palpated, the patient may very well complain of pain. Those occur more frequently in regions that are affected by periosteum inflammation.

The doctor cannot say whether it is an acute or chronic periosteum inflammation – just by palpating the body. An X-ray examination can provide information for a specific diagnosis, which sometimes makes it possible to state whether the form is acute or chronic.

However, it must be taken into account that X-rays only provide further evidence if the patient has been complaining of classic symptoms of bone inflammation for a long time. Likewise, only severe forms of the disease are visible – by means of X-ray examination .

If there are any doubts as to whether periosteum inflammation is actually present, an MRI can be ordered as a further step. A skeletal scintigraphy can also provide information as to whether the patient is affected by a corresponding disease. However, both diagnostic options only bring certainty if a serious form of periosteum inflammation is present.

complications

Periosteum inflammation causes significant limitations and discomfort in everyday life for those affected. In most cases, those affected suffer from relatively severe bone pain in the affected body regions. This pain usually occurs as rest pain or pressure pain. The result: sleep disorders and the associated increased irritability and overall poor well-being. Tiredness and exhaustion are also typical complications of pronounced periosteum inflammation.

In general, the resilience of those affected also decreases sharply – mental problems such as depressive moods or anxiety disorders can occur. Swelling and redness usually also occur, which hurt when pressure is applied. Occasionally, the affected areas fill with water, which can lead to edema and infection in the long term. When treating periosteum, major complications are rare.

In addition to the typical side effects from prescribed painkillers and anti-inflammatory drugs, allergic reactions to the ointments and bandages used can occur. If an operation is necessary, however, major complications can arise. Infections in the area of ​​the intervention occur relatively frequently, or wound healing disorders or post-operative bleeding occur. When using IV fluids, there is a risk of inflammation and blood clots.

treatment and therapy

The treatment of an incipient periosteum inflammation can already begin with the cooling of the attacked areas. Curd wraps or cold packs are suitable home remedies. In the case of purulent periostitis, high-dose antibiotic drugs are used. Pain-relieving drugs are used to counteract the pain as an effective remedy for periosteum inflammation.

To support therapy, the treating physicians offer massages and physiotherapy exercises and prescribe anti-inflammatory drugs.These should strengthen the muscles and promote blood circulation in the periosteum. Substances to be applied externally, such as ointments and other rubs, also promote the healing of the periosteum.

In the case of very strong and long-lasting pain sensations, a catheter placed close to the spinal cord can be useful in the case of periosteum inflammation, which ensures a so-called continuous epidural blockade and can optimally reduce the pain.

The stimulus conduction of the pain is interrupted and the blood flow to the periosteum increases in this area. This special catheterization is common in the case of periosteum inflammation on the tibia. In addition, the locally introduced pain-relieving drugs are also an effective help against the permanent pain.

prevention

There is no doubt that it is possible to prevent the development of periosteum inflammation. Extensive warm-up training for the muscles and a slow increase in performance as a prophylactic against periosteum inflammation should be considered particularly useful in the case of intensive physical activity. Strong vibrations and impacts during training must be prevented by appropriately cushioning footwear.

Periostitis in most cases results in involuntary avoidance of exertion because of pain and may result in some temporary reduction in quality of life. The periosteum is characterized by different types and forms.