periostitis
Introduction
Introduction Periostitis is an infective periosteal injury caused by periosteal and periosteal vasodilatation, hyperemia or subperiosteal hemorrhage, periosteal hyperplasia and inflammatory perfusion, and periplasmic mucosal injury or purulent bacterial invasion. The systemic symptoms of periostitis are mild. Only in acute blood-borne osteomyelitis, systemic symptoms are severe. Forequarters symptoms are systemic burnout, followed by body aches, loss of appetite, chills, severe cases can have chills, more galloping fever up to 39 ~ 41 ° C, irritability, pulse fast, and even sputum, coma and other sepsis Symptoms, meningeal irritation can also occur.
Cause
Cause
1. Usually less physical activity, poor coordination of the body, sudden increase in exercise, training and jumping, active time is too long. During the running and jumping process, the foot is repeatedly forced to squat, the calf muscles are in a state of tension for a long time, and the muscles are constantly involved. The calf and periosteal tear injury, periosteal and periosteal vasodilatation, congestion, edema, subperiosteal hemorrhage, hemorrhage, periosteal hyperplasia and inflammatory changes.
2. Causes purulent bacterial infection after trauma.
Examine
an examination
Related inspection
CT examination of bone and joint and soft tissue
1. Systemic symptoms: In acute blood-borne osteomyelitis, systemic symptoms are severe. Forequarters symptoms are systemic burnout, followed by body aches, loss of appetite, chills, severe cases can have chills, and more hyperactivity reaches 39 ~ 41 ° C, irritability, pulse fast, even convulsions, coma, etc. Symptoms of sepsis can also cause meningeal irritation. This patient often has anemia dehydration and acidosis. Acute osteomyelitis caused by injury, unless there are serious complications or a large number of soft tissue injuries and infections, generally systemic symptoms are mild, more infections are more limited and less sepsis, but should pay attention to the risk of anaerobic infection.
2. Local symptoms: In the early stage of blood-borne osteomyelitis, there are local severe pain and jumping pain, muscles have protective tendons, and the limbs do not dare to move. The affected area is swollen and tender. If the lesion is close to the joint, the joint may also swell, but the tenderness is not significant. When the abscess penetrates the bone and the periosteum to the skin, it fluctuates. After piercing the skin, it forms a sinus and it does not heal for a long time.
Diagnosis
Differential diagnosis
The following should be identified:
1. Cellulitis: The symptoms of systemic poisoning are mild, local inflammation is extensive, and the range of tenderness is also large.
2. Acute septic arthritis: swelling, tenderness in the joint space and not at the bone end, the joint movement almost completely disappeared. When in doubt, the joint cavity puncture fluid examination can confirm the diagnosis.
3. Rheumatoid arthritis: The general condition is mild, the fever is low, the local symptoms are also mild, the lesion is in the joint, and there are often multiple joints involved.
