Physiologic periostitis

Andrew Murphy and Dr Andrew Dixon et al.

Physiologic periostitis describes the normal presence of smooth bilateral diaphyseal periosteal new bone in the humeri, femora or tibiae of infants aged 1 to 6 months. It can be observed in both preterm and term infants. The etiology is unclear but may simply relate to rapid growth.  

  • long bones: tibiae, humeri, and femora relatively equally affected
  • diaphyseal smooth periosteal reaction which may extend partly into the metaphyseal region, but not to the end of the metaphysis
  • always bilateral and usually symmetric in extent 
  • organized and lamellar 2
  • often concentric around the bone but may predominate on one aspect
  • when tibial, it is always seen along the medial aspect
  • no fracture or metaphyseal corner lucency
  • no flat bone involvement

Normal uptake is observed in contrast there is high uptake in trauma 2.

  • trauma/non-accidental injury
    • not symmetric, lucent fracture line, soft-tissue swelling
  • osteomyelitis
    • not symmetric, usually metaphyseal, soft-tissue swelling
  • Caffey disease (infantile cortical hyperostosis)
    • same age group, flat bone involvement, soft-tissue swelling  

Article information

rID: 65511
Synonyms or Alternate Spellings:
  • physiological periostitis

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