Periosteal reaction from venous stasis

Case contributed by Dr Laughlin Dawes

This leg x-ray shows periosteal reaction around tibia and fibula. There is also soft tissue calcification medial to the tibia. 

Case Discussion

This patient had chronic venous disease of the lower limbs, and the soft tissue calcification probably represents phleboliths within varicose veins.

The causes of bilaterally symmetrical smooth periosteal reaction include:

  • hypertrophic osteoarthropathy
  • pachydermoperiostitis
  • vascular insufficiency
  • thyroid acropachy
  • flourosis

Periosteal reaction due to venous stasis is typically solid and undulating, and initially separated from the cortex, as in this case.

Image contributed by: Dr Laughlin Dawes.

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Case information

rID: 35918
Case created: 24th Apr 2015
Last edited: 6th Nov 2015
Inclusion in quiz mode: Included

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