Definition: periostitis
Periostitis is an inflammatory change in the periosteum, resulting from a variety of causes, often accompanied by severe pain and general systemic symptoms and can cause life-threatening conditions.
Causes of periostitis
In most cases, periostitis is caused by chronic overloading. Especially athletes, who suddenly increase their training intensity without waiting for the corresponding training effects, are affected by this overload. Running or standing on too hard a surface or with the wrong shoes can also accelerate or cause inflammation of the periosteum.
Furthermore, there is also the possibility that an inflammation of the periosteum is caused by a bacterial infection. The prerequisite for this is the penetration of a pathogen into the body. Bacterial infection often occurs after an accident, resulting in deep skin injuries through which the corresponding pathogens can penetrate.
If they reach a nearby bone, there is in principle the possibility that they will infect the periosteum. Even after surgical interventions in which bone has been exposed, e.g. after the insertion of a knee or hip endoprosthesis, there is a risk that corresponding pathogens may get near the bone and periosteum and infect them. In comparison, however, periosteitis resulting from overloading is much more common.
Pathogenesis of periostitis
Overuse or infection of the periosteum causes swelling of the periosteum, also known as periosteal oedema. In this stage of inflammation, connective tissue structures and increasing ossification processes are involved in the inflammatory process. This swelling leads to increased pressure and tension on the periosteum, which in turn leads to irritation of the nerve structures. This irritation is then perceived in the form of pain. The body usually reacts with a corresponding defensive reaction, especially if it is a bacterially caused periosteitis.These include activation of the immune system, white blood cells (leukocytes are elevated), possibly fever and increased inflammation levels (elevated CRP levels).
Symptoms of periostitis
By these symptoms one recognizes an inflammation of the periosteum Pain At rest under pressure under stress Swelling Overheating Reddening of the skin over the affected area Restricted mobility and functionality of the body part Furthermore, general symptoms such as In the blood count, especially an increased leukocyte count and an increase in CRP can indicate an inflammation of the periosteum.
- Pain At rest with pressure under load
- In peace
- On print
- Under load
- Swelling
- Overheating
- Reddening of the skin over the affected area
- Restricted mobility and functionality of the body part
- In peace
- On print
- Under load
- Weariness,
- General discomfort and
- Fever occur.
In osteomyelitis, pain is caused by the inflammatory cells that are produced in the body during the disease. These cells are believed to be effective against periostitis, but at the same time they stimulate the nerve fibers that transmit pain to the brain.
Pain in periostitis is also a warning signal from the body. Since they are usually stronger when under stress than at rest, they virtually urge the person affected not to exert themselves too much. This allows the bone to recover and the inflammation to heal.
Besides pain and redness, swelling is a typical sign of inflammation. In the case of periostitis, swelling is often not immediately visible because the processes in the body take place slightly below the skin. However, since in most cases the shin bone is affected by the periosteitis and very little tissue lies over the bone, the swelling usually appears early.
The swelling in periostitis is also caused by the inflammatory cells that the body sends into the tissue to fight off the disease. The many cells take up a lot of space for themselves, and there is also an increased accumulation of fluid. This results in swelling at the site of inflammation.
