Florid reactive periostitis is a rare benign lesion, included in a group of reactive bone and soft tissue lesions that create a frequent diagnostic problem.
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Epidemiology
Florid reactive periostitis occurring often in the 2nd and 3rd decade of life with a male to female ratio of 1 to 1.5, even though the affected age group stated in the literature varied from 5 to 70 years 1-4.
Pathology
The lesion is usually formed in the hand phalanges, mainly in the proximal phalanx, and is characterized by an excessive osteoblast formation in a fibrous proliferative stroma arising at the level of the finger periosteum.
Radiographic features
Soft tissue expansion and periosteal bone new bone formation that may seem as lamellar or mature bone. The cortex is typically intact.
Differential diagnosis
Differential diagnoses include 5:
- myositis ossificans
- bone tumors, e.g. osteosarcoma, giant cell tumor
- infection, e.g. septic tenosynovitis, soft-tissue abscess, cortical osteomyelitis
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