Pain in the periosteum of the tibia

On palpation, a lump will be visible around the bone. It is caused by fractures, bruises or inflammation in the muscles and bones. The patient complains of pain and swelling.

Inflammation of the skin around the bones (periostitis)

Periosteum is an inflammation of the periosteum that first occurs on the surface of the periosteum and then spreads to the other layers. The periosteum is a soft connective tissue that covers the entire surface of the bone with a thin layer. It acts as a link between the tooth and all surrounding muscles and has a protective function for the bone. The first symptom of periostitis is a slight swelling of the gums, which is accompanied by pain. The disease can be infectious or aseptic (without the involvement of pathogens). Left untreated, it can quickly lead to osteoperiostitis if the inflammation invades the bone tissue, as well as other dangerous complications.

• swelling and redness;
• a painful feeling when pressure is applied to it;
• Increased pain at night;
• abnormal tooth mobility;
• Increased general and local temperature;
• swollen lymph nodes;
• Malaise, weakness, loss of appetite.

It is important to remember that dental periostitis usually progresses quickly. Over time, symptoms worsen and new ones appear. Tissue swelling can affect the lip, neck, cheek, temple area, and ear. The pain becomes throbbing, indicating the formation of a pus abscess.

Diagnosis of periostitis

Due to the pronounced symptomatology of the inflammatory process in the periosteum, the diagnosis can be made with high accuracy, even with visual examination.

To confirm the diagnosis, the doctor may recommend additional tests:

• a detailed blood test;
• X-ray of the affected area;
• orthopantomogram (image of the entire jaw);
• Computed tomography and magnetic resonance imaging.

Differential diagnosis is made on the basis of clinical and laboratory findings, since periostitis can be confused with other diseases such as acute osteitis, periodontitis, abscesses of all kinds, phlegmon, lymphadenitis and other temporomandibular pathologies.

ICD-10

Purulent periostitis is an inflammatory process caused by purulent bacteria in the periosteum. It is usually associated with inflammation of other parts of the bone (osteperiostitis). It can be primary (inflammation first occurs in the periosteum, and then spreads to adjacent tissues) or secondary (the purulent process spreads from the bone or adjacent soft tissues to the periosteum). Contact infection and hematogenous spread of infection are possible. Treatment of jaw periostitis is performed by dentists, treatment of orbital periostitis by ophthalmologists, treatment of other local periostitis (long bones, pelvis, ribs, etc.) is performed by orthopedists/traumatologists.

causes

Purulent periostitis is most often caused by staphylococci and streptococci. In addition, pseudomonads, Klebsiella, Proteus, E. coli, meningococci, gonococci and clostridia, which cause a special type of deposit infection, can also provoke purulent periostitis. Less often, the disease is caused by other pathogens that penetrate the periosteum: candida, mycobacteria, pneumococci, brucellosis, shigella, salmonella, etc. Sometimes the infectious agent cannot be identified due to the lysis (destruction) of germs.

As a rule, purulent periostitis of the jaw is a complication of caries, alveolitis, periodontitis and odontogenic maxillary sinusitis; the periosteum can also be affected by wounds on the face, oral mucosa, and open fractures of the jaw. Periosteum of the long bones (usually the humerus, tibia, and femur) occurs in trauma wounds, open fractures (particularly gunshot wounds), and hematogenous spread of infection; it is also an obligatory part of the suppuration process in osteitis.

The short and flat bones (shoulder blade, clavicle, hip bone, etc.) are less frequently affected, according to the observations of trauma and orthopedic specialists; the causes are the same as in inflammation of the long bones of the long tube. Purulent periostitis of the pubic conjunctiva can occur after herniotomy, gynecological and urological operations. Periostitis of the eye can be caused by infectious diseases (scarlet fever, measles, pharyngitis, influenza), sinusitis (inflammation of the sinuses), tooth decay, and blunt trauma to the surrounding soft tissues.

causes

In medicine, the following causes of periostitis are mentioned:

• trauma, which can manifest itself in the form of bruises, dislocations, broken bones, dislocations and soft tissue wounds;
• Inflammation of the adjacent tissues from a pathological focus near the periosteum;
• Toxic. Some diseases produce toxins in the body that enter the periosteum. Toxic substances are produced in the diseased organ and transported throughout the body via the blood or lymphatic system;
• Allergic. The periosteum reacts in this way to allergens that enter the periosteum;
• Specific, the disease arising on the background of tuberculosis or syphilis.

symptoms

The symptoms of periosteum usually depend on the type of bone and are manifested by the following reactions of the body:

• In the acute form of the disease, there is a slight, limited swelling. Pain and a localized increase in temperature occur on palpation. The symptom is lameness;
• In the fibrotic form, the swelling is firm and not painful on palpation. There is no local rise in temperature, and the skin is mobile in the affected area;
• In the ossifying form, the swelling is sharply defined, hard in texture, and has an uneven surface. There is no pain and local fever on palpation;
• Acute purulent periosteum is manifested by severe pain, deterioration in general condition, fever, increased breathing and pulse rate, weakness, rapid fatigue and depression. A painful swelling is noted that is hot to the touch, and the inflamed tissue is tense.

folk remedies

The condition can be treated with folk remedies. Such therapy has an anti-inflammatory, decongestant and pain-relieving effect.

To get rid of pathology, kombucha can be used. Chop the plant, pour 250 ml of boiling water over it and let it steep for 20 minutes. The remedy should be taken 1 teaspoon before each meal.

Often an ointment is also made from such a plant. The quinoa root should be chopped up. For 100 g of raw material, take 200 g of butter and melt it in the steam bath. The ingredients are mixed and left for 30 minutes. When the gel has cooled, it should be applied to the affected areas of the feet. It is better to store the remedy in the refrigerator.

Periostitis can be treated at home with plum root. Grate the raw material to get 200 g. Then pour 0.5 liters of alcohol over them. The mixture should brew for 5 days, after which the inflamed area is rubbed with a warm scarf.

Poultices are often used to treat this disease:

1. Decoction of lemon balm. Pour 400 ml of boiled water over 2 tablespoons of the dried raw material. Infuse the drug for 4-5 hours, and then wait for it to cool. Soak a bandage in the liquid, place it over the inflamed area, and secure with cling film. Maintain the application for 6-8 hours.
2. soda solution. Pour 250ml of water over 2 tablespoons of powder. Mix the ingredients and then soak gauze with the preparation, which is applied to the affected shin. It is recommended to protect the compress with polyethylene. Duration of exposure - 4-5 hours.
3. Application of white clay. The powder (40-60 g) is mixed with water to a creamy consistency. Sunflower oil is applied to the affected area, followed by a clay compress. The site should be protected with a gauze bandage. The area should be slightly moistened with water during treatment. The treatment time is 45-60 minutes.
4. A decoction of dandelion roots is used to relieve inflammation of the periosteum of the lower leg. Pour 500 ml of boiling water over 1 tablespoon of the raw material and leave for 3-5 minutes over low heat. The resulting preparation should be cooled and drunk one glass at a time on an empty stomach. It is better to take the medicine in the morning.

treatment methods.

An experienced doctor will only start treating periosteum after determining the exact cause of the disease. Each type of the above pathology requires a special approach.

In case of periosteum inflammation, the patient should stay in bed and be treated with medication:

If the treatment is positive, after about 1-2 weeks the patient can be prescribed drugs:

The above treatments accelerate healing, disinfect, improve periosteal tissue perfusion and nutrition, and resorb periosteal thickening.

Complete healing occurs after about 3-4 weeks if all the doctor's recommendations are strictly followed.

Chronic forms of the disease require prolonged treatment, which is carried out on an outpatient basis. It is based on the same principles as the simple form of the disease. With severe pain in the area of \u200b\u200bthe lesion, novocaine blockade can be performed.

In the last stages of treatment, the doctor may recommend additional blockade:

With the above disease, hot compresses and treatments should not be used, as they promote rapid and uncontrolled spread and intensification of the inflammatory process. During the treatment and recovery of the damaged periosteum, the amount of movement should be strictly controlled.

The treatment of purulent periosteum requires surgery and drug therapy. The periosteum is surgically opened and the abscess is carefully removed.

Possible complications

Periosteum inflammation is dangerous because it can lead to complications that are fatal to the patient. It is important to see a good specialist at the first suspicion and follow all recommendations.

Advanced forms of suppurative periosteum can cause the following serious complications:

Osteomyelitis is the spread of infection from the periosteum to the bone, the nucleus. The patient has a high body temperature of up to 40 °C and shows all the symptoms of intoxication. There is swelling of the affected area and pain. Eventually, due to tissue necrosis, a fistula forms and pus comes out.

If the infection gets into the blood and lymph and spreads throughout the body, the patient develops sepsis, which often leads to death. An abscess or phlegmon develops when the purulent process spreads to the surrounding soft tissues. A very dangerous condition occurs with mediastinitis, when the chest cavity becomes infected.

In the course of these adverse consequences of the periosteum, the tissues and organs adjacent to the affected periosteum are softened and destroyed. In all these cases, the disease requires urgent medical attention.

ICD-10 code

Periosteal inflammation can occur in different parts of the body. It is often caused by trauma, bruises, severe cuts, or fractures. The causes of periosteum inflammation also include interactions with other sources of inflammation (muscles or bones).

The disease can also be caused by allergic or inflammatory processes in other tissues, which then spread to the periosteum and progress further. Less commonly, periostitis is caused by a general disease or a specific disease that causes toxins to build up in the body.

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Symptoms of periosteum inflammation

The main symptoms of periostitis are pain when moving, discomfort and slight swelling in the inflamed areas. The color of the skin does not change and there are no spots, redness or bluish discoloration. If the periosteum is caused by a bruise or fracture, all symptoms and the inflammation will subside after 2 to 3 weeks. If there is aggravation and fibrous overgrowth of the bone, the disease progresses to a chronic stage. This stage is characterized, among other things, by a reddening of the skin. If the periosteum is not treated therapeutically at this stage, it can lead to serious complications at a later stage, leading to damage to the bone and purulent periosteum.

inflammation of the shin bone (periostitis)

This type of disease is caused by heavy and prolonged physical stress without prior preparation. The main symptom of this type of periosteum is pain in the inner part of the shin, which occurs some time after the load. Shin scalp infections are very common in first-year soldiers or in athletes after a break in training or after particularly difficult exercise that is unfamiliar to the body. The external symptom of the disease is a slight swelling of the affected area. There are no lesions on the skin. There is also a painful, uncomfortable feeling when touching the lower leg. In the first 20 days, the periosteum cannot be seen on the X-ray; only then can the diagnosis be made by an X-ray and a medical examination.

If shin scalp inflammation is suspected, the patient should immediately stop physical activity to reduce the risk of developing and complicating the disease.

Periostitis of the tibia

Periostitis most commonly occurs in areas where the bone is poorly protected by soft tissue. The causes of the disease are bruises and fractures. The ulna and tibia are particularly at risk. In most cases, the inflammatory process in these areas resolves spontaneously within a few weeks.

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Ossifying periostitis of the tibia is the result of chronic inflammation of the periosteum.

The result is the formation of new bone from the inner layers of the periosteum. It may be accompanied by inflammation.

The ossifying form develops in necrotic or inflammatory foci at the level of the bone, under varus ulcers, around inflamed joints, foci of tuberculosis.

Once the irritation that triggered this process has subsided, bone formation stops and the compact and compact osteophytes are free to change their structure.

Fibrous periostitis of the shin slowly develops as a result of prolonged irritation and goes into a chronic form.

It manifests itself as a callus-like thickening of the periosteum, which is closely connected to the bone. It results from ulceration of the tibia, bone necrosis, and chronic inflammation of the joint. Excessive growth of fibrous tissue can even lead to bone destruction.

Purulent periostitis occurs when the periosteum is damaged and infected.

In this case, the infection can get here from other organs or through the hematogenous route (jaw periostitis after caries, pneumoconiosis and metastatic periostitis). It is always accompanied by chronic purulent osteitis.

This form is characterized by a hyperemic periosteum with a fibrous or serous exudate. After purulent infiltration, the periosteum easily detaches from the bone.

Pus accumulates between the bone and periosteum, causing abscess formation and, in some cases, bone necrosis.

If the pus is removed in time, the inflammatory process can be stopped.

However, purulent periosteum inflammation can also spread to the soft tissues and bones.

Due to the abundance of pus, the periosteum can tear and bone will form where the tears are.

Serous albuminous periostitis is an inflammation of the periosteum that produces an exudate in the form of a serous, mucous liquid with a high albumin content (up to 2 liters).

Treatment of periosteum inflammation of the tibia

If the periosteum is not accompanied by a purulent infection, the person concerned can be treated at home. The doctor prescribes antibacterial medicines for the common cold and a number of painkillers.

The main task is to reduce inflammation. If the patient engages in sports, he is advised to either stop training altogether.

Or at least a less aggressive workout that doesn't stress the inflamed periosteum.

Inflammation of the periosteum of the lower leg lasts much longer than soft tissue injuries (up to 3 weeks).

If the irritation lasts longer, the disease develops into a purulent or ossifying inflammation of the skin around the bones (periostitis).

If pus forms with periostitis of the shin, surgical intervention is required.

Types of foot infections

Inflammation on the foot is very easy to get, even at home. Knee bruises, abrasions and abrasions are typical causes of various inflammations on the foot. Germs can also penetrate the soft tissues of the foot:

• for skin scratches – eg allergies to insect bites;
• fungal diseases with cracked skin;
• diabetic ulcers;
• varicose veins;
• Injections under unsanitary conditions - e.g. B. drug addiction;
• Injuries and wounds – e.g. B. in athletes or military personnel;
• Introduction of microflora from primary inflammatory foci into the blood or lymph.

Purulent soft tissue inflammation is caused by purulent bacteria, mainly staphylococci. At the initial stage, blood microcirculation is disrupted, which is accompanied by damage to the tissue structure. If the soft tissue inflammation of the leg is not treated promptly, it will swell and cause pain as the muscle tissue expands from the accumulated fluid and sends signals through the neuromuscular junction. In most cases, the patient takes a painkiller and forgets about the problem. In the meantime, the inflammation passes into the suppurative stage, when neuromuscular connection is lost and pain ceases, but pus accumulates. Two variants of purulent inflammation are known:

• Abscess. Commonly known as an abscess. It originates in the muscles and subcutaneous tissue and has well-defined borders within a purulent covering that forms as the body's defense against infection.
• phlegmon disease. Acute diffuse inflammation of the subcutaneous tissue, which does not have clear boundaries and easily spreads to the entire limb.

Anaerobic infections are also a major problem for the legs. The most common leg soft tissue infections associated with this type of infection are:

• The keratitis. It manifests itself in the form of blisters on the skin, redness and bleeding. It is caused by streptococcus and can result from contact with a person who has a streptococcal infection such as B. had tonsillitis. This type of inflammation rarely goes away on its own, but don't count on it. Advanced cases of rust infections take several months to heal.
• gangrene – This is tissue death. Pathogenic bacteria from the Clostridia family that live in soil and dust. Gangrene can only be treated by amputation, so it is very important to disinfect wounds and seek immediate medical attention if injured.

Treatment methods for inflammation of the feet

Inflammatory processes are treated in several stages. If the disease has progressed to a purulent stage, the pus must be surgically removed and the wound bandaged. Subsequently, and in milder stages, anti-inflammatory pharmacotherapy is prescribed - a course of antibiotics in the form of tablets or injections, depending on the origin and severity of the infection. It is important to choose the right drug, for which a bacterial culture is established. The patient is given plenty of fluids to flush the toxins out of the body as quickly as possible.

In the recovery period, physiotherapy is recommended to regenerate the circulatory and lymphatic systems. Shock wave therapy is effective in this regard and promotes early regeneration of soft tissues. It can be performed at our 'Medcenter Plus' clinic.

Oleg Petrovich Tatarinov

Doctor of the highest category, neurologist, physiotherapist, UWT specialist, leading specialist of Zdorovye Plus.

medical experience more than 40 years

treatment of the disease

The therapy regimen is always selected individually. If the condition is recent, it is usually treated conservatively. The patient is discharged home:

Oral hygiene is always carried out. If there is an indication to remove the broken fragments, they are extracted and replaced with dentures. Physiotherapy can speed up the healing process.

In advanced cases, surgical treatment is performed. In this case, the treatment plan looks something like this:

• The doctor examines the condition of the mouth and determines the cause of the disease.
• A local anesthetic is injected into the affected area. Once the anesthetic has taken effect, an incision is made in the pus-filled gums.
• The open area is cleaned of the purulent exudate and rinsed. If necessary, a drainage tube is inserted. This is necessary so that necrotic masses do not form again in the cavity.
• The doctor will treat the tooth if it can be saved. The root canals are filled and a filling is placed. If the tooth cannot be healed because the roots are severely damaged, extraction is performed.
• The patient is prescribed antibiotics, painkillers and anti-inflammatory drugs.

The most important is., After the treatment, the patient must come for a check-up. This is necessary to avoid recurrence and create optimal conditions for a speedy recovery.

prophylaxis

As periosteum inflammation is often caused by tooth decay or trauma, it is necessary to take optimal care of teeth and gums. Prevention consists of the following measures:

• morning and evening hygiene;
• rinsing the mouth after each meal;
• Timely and correct treatment of emerging dental problems;
• Regular cleaning of teeth with dental floss;
• Wearing dental glasses for sports that are hazardous to health;
• Go to the dentist once a year;
• Annual dental hygiene in the dental office.

If a tooth starts to hurt and the gums turn red, you should immediately make an appointment with the dentist. If a pustule has formed, do not open it yourself. Such measures aggravate the course of the disease and lead to serious complications.

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