Periosteal lesions are non-specific changes to the underlying bone that can occur due to a range of diseases or other problems affecting the skeleton (Ortner, 2003). These lesions occur because the periosteum, which is the dense layer of connective tissue enveloping the bone, maintains osteoblastic capability throughout life. The lesions are not restricted to infections, but rather can be a result of any bone formation following a traumatic event affecting the skeleton (Ortner, 2003). Waldron (2009) agrees that periosteal lesions and expands on that by stating that the lesions can also be a lone finding. There are many different variants of periosteal lesions due to the fact that they can have various causations. Resnick and Niwayama
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However, Ortner (2003) notes that the non-specific responses are usually due to bacterial infections and the specific responses are associated with tuberculosis meningitis, meningoencephalitis, and pachymeningitis. These usually affect the deeper structures of the original bone substance, especially when they are the result of tuberculosis meningitis. The inflammatory reactions are exhibited by a relatively fresh process. In both non-specific and specific meningitis, changes are expressed by smooth and flat plate-like newly built bone formations that are oriented tangentially to the endocranial surface (Ortner, 2003). Several layers of this first expression can be possible and the lesions are usually found in digital impressions; however, they can also be spread over larger areas in an advanced stage. In these advanced stages, the contours become indistinct and the plate-like character will be lost during the remodeling process. In specific lesions only, the small digital impressions become organized and filled by newly built bone formations (Ortner, …show more content…
These processes affect the bone surface and, in advanced stages, the deeper structures of the original bone substance. These changes are expressed by structures similar to the inflammatory changes described above. However, unlike in the inflammatory changes, the trabeculae show a regular development (Ortner, 2003). The endocranial tumorous reactions are commonly caused by diseases such as meningioma (Ortner, 2003). They resemble the external reactions described above, but with very little differences. They are expressed by irregular bulging of dense newly built bone formations. These reactions do not exhibit trabecular growth (Ortner, 2003). This is the last endocranial reaction that can occur in the human body for periosteal lesions. The final external reaction would be the circulatory reaction. This is commonly seen in periostitis and can be caused by hypertrophic pulmonary osteoarthropathy or Bamberger-Marie disease (Schultz, 1987; Ortner, 2003). These are exhibited by thick layers of new bone formation at the original bone surfaces. There are sometimes short and bulky trabeculae, which are similar to changes observed in hemorrhagic processes. Finally, stratified formations are frequently seen that is a sign of recidivism for this form of the periosteal reactions (Ortner,
However, Ortner (2003) notes that the non-specific responses are usually due to bacterial infections and the specific responses are associated with tuberculosis meningitis, meningoencephalitis, and pachymeningitis. These usually affect the deeper structures of the original bone substance, especially when they are the result of tuberculosis meningitis. The inflammatory reactions are exhibited by a relatively fresh process. In both non-specific and specific meningitis, changes are expressed by smooth and flat plate-like newly built bone formations that are oriented tangentially to the endocranial surface (Ortner, 2003). Several layers of this first expression can be possible and the lesions are usually found in digital impressions; however, they can also be spread over larger areas in an advanced stage. In these advanced stages, the contours become indistinct and the plate-like character will be lost during the remodeling process. In specific lesions only, the small digital impressions become organized and filled by newly built bone formations (Ortner, …show more content…
These processes affect the bone surface and, in advanced stages, the deeper structures of the original bone substance. These changes are expressed by structures similar to the inflammatory changes described above. However, unlike in the inflammatory changes, the trabeculae show a regular development (Ortner, 2003). The endocranial tumorous reactions are commonly caused by diseases such as meningioma (Ortner, 2003). They resemble the external reactions described above, but with very little differences. They are expressed by irregular bulging of dense newly built bone formations. These reactions do not exhibit trabecular growth (Ortner, 2003). This is the last endocranial reaction that can occur in the human body for periosteal lesions. The final external reaction would be the circulatory reaction. This is commonly seen in periostitis and can be caused by hypertrophic pulmonary osteoarthropathy or Bamberger-Marie disease (Schultz, 1987; Ortner, 2003). These are exhibited by thick layers of new bone formation at the original bone surfaces. There are sometimes short and bulky trabeculae, which are similar to changes observed in hemorrhagic processes. Finally, stratified formations are frequently seen that is a sign of recidivism for this form of the periosteal reactions (Ortner,