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Periosteal reaction due to venous stasis

Case contributed by Ciro Menna Barreto Duarte
Diagnosis almost certain

Presentation

Ulcers in the lower extremities.

Patient Data

Age: 65 years

Legs X-rays

x-ray

Radiographs show an extensive bilateral periosteal reaction, more on the right side, associated with subcutaneous calcifications.

Case Discussion

The patient has a known history of diabetes mellitus, chronic kidney disease stage 5, and venous insufficiency. She was admitted by nephrology for dialysis and has a history of chronic lower limbs ulcers for more than four years.

On examination: ulcer extensive in the right lower limb, shallow, with no signs of necrosis but presenting fibrin. Important lymphedema, but warmed and perfused limb. Conclusion: Chronic venous disease, with trophic changes without infection.

The radiographs show soft tissue calcification due to dystrophic changes, and periosteal reactions, which, in this case, are probably related to chronic venous stasis. 

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