Diffuse periosteal reaction due to chronic venous insufficiency

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Swollen painful legs, right worse than left. Recent minor fall. Ulcers over lower leg.

Patient Data

Age: 75 years
Gender: Male

Alignment is normal. No fracture. Diffuse smooth undulating periosteal reaction of the fibula and to a lesser extent the tibia. Increased soft tissue density and multiple small calcified foci in the soft tissues. Dressing noted over the lower leg. No signs of osteomyelitis. 

Case Discussion

This patient had a known and very long history of chronic venous insufficiency. He had a large venous ulcer over the right lateral lower leg with the typical skin changes of venous stasis. His left leg was similar but not as severe. 

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