[2 cases of the coronoid process osteitis. Exceptional localization of mandibular osteitis].
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Adult↗
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[Chronic sclerosing osteitis of the clavicle. A manifestation of chronic recurrent multifocal osteitis].
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Adolescent↗
Effect of lavage on the incidence of localized osteitis in mandibular third molar extraction sites.
Four hundred twenty-two mandibular third molars were extracted in 211 patients. After extraction, one half of the surgical sites were subjected to a 175 ml. lavage with normal saline solution, and the other half received a lavage of less than 25 ml. of normal saline solution. Comparisons revealed the following: 1. The overall incidence of localized osteitis was 8.3 per cent (thirty-five of 422 sites). 2. Localized osteitis occurred at twelve of 211 (5.7 per cent) sites which were subjected to the higher-volume lavage. 3. Localized osteitis occurred at twenty-three of 211 (10.9 per cent) sites which were subjected to minimal lavage. 4. The incidence of localized osteitis was determined in the various age groups as follows: ages 15 to 20, 5.0 per cent; ages 21 to 35, 10.4 per cent; ages 26 to 30, 14.7 per cent. 5. Localized osteitis occurred at eight of 175 (4.5 per cent) partial-impaction sites, whereas it occurred at twenty-seven of 246 (11 per cent) complete-impaction sites. 6. The incidence of localized osteitis at extraction sites in female patients taking oral contraceptives was 19.4 per cent (seven of thirty-six sites). 7. Postoperative infection occurred at seven of 422 extraction sites (1.4 per cent); six of these occurred at sites which were subjected to minimal lavage. These results indicate that the use of a 175 ml. lavage with normal saline solution after extraction of mandibular third molars will significantly reduce the incidence of localized osteitis to approximately one half of that observed when only a minimal-volume lavage is used. The results also suggest that age, type of impaction, and whether the patient is taking oral contraceptives are all important factors to be considered in the incidence of localized osteitis.
Adolescent↗
Frequency of alveolar osteitis (dry socket) at Kenyatta National Hospital Dental Outpatient Clinic--a retrospective study.
The objectives of this study were to determine the frequency of alveolar osteitis at Kenyatta National Hospital (KNH), most affected age group and the reasons for underlying extractions. Out of 8,393 extractions 273 (3.3%) developed alveolar osteitis. 98.5% of the teeth that developed alveolar osteitis were molars and premolars. 52% of the patients that developed alveolar osteitis were females and 48% were males. The mandible was more affected than the maxilla. The percentage distribution of alveolar osteitis according to age groups 10-19 year, 30-39 years, 40-49 years, 50-59 years and 60-69 years were 6.2%, 53.1%, 23.8%, 5.5%, 4.8% and 2.9% respectively. On the average, patients reported with alveolar osteitis 5.7 days following extraction. Out of 8,393 extractions, 72.5% were due to dental caries, 18% were due to periodontitis and the rest were due to other causes. It was concluded that the frequency and average, patients reported with alveolar osteitis 5.7 days following extraction. Out of 8,393 extractions, 72.5% were due to dental caries, 18% were due to periodontitis and the rest were due to other causes. It was concluded that the frequency and pattern of development of a alveolar osteitis at KNH was similar to that reported in developed countries.
Adolescent↗
Intravenous calcitriol in the treatment of refractory osteitis fibrosa of chronic renal failure.
Osteitis fibrosa, a frequent complication of chronic renal failure, is characterized by increased rates of bone formation and bone resorption due to increased secretion of parathyroid hormone (PTH). Effective treatment with oral calcitriol is often impossible in patients with osteitis fibrosa, because low doses may cause hypercalcemia. Because short-term infusions of intravenous calcitriol are capable of suppressing the secretion of parathyroid hormone in patients with uremia without causing hypercalcemia, we evaluated the effectiveness of long-term intermittent calcitriol infusions (1.0 to 2.5 micrograms three times weekly, during dialysis) in treating severe osteitis fibrosa in 12 consecutive patients on hemodialysis whose disease was refractory to conventional therapy. After a mean (+/- SE) treatment period of 11.5 +/- 1.4 months, the mean bone-formation rate declined from 1642 +/- 277 to 676 +/- 106 microns 2 per square millimeter per day (P less than 0.01) in the 11 patients who successfully completed the study. Similar reductions occurred in the osteoblastic osteoid (18 +/- 3 to 9 +/- 2 percent; P less than 0.01) and the degree of marrow fibrosis (6.2 +/- 1.7 to 3.5 +/- 1.3 percent; P = 0.01). Concomitant serum biochemical changes included increased calcium levels (2.55 +/- 0.03 to 2.67 +/- 0.05 mmol per liter; P less than 0.01), decreased alkaline phosphatase levels (489 +/- 77 to 184 +/- 32 U per liter; P less than 0.001), and decreased levels of PTH (amino-terminal, 172 +/- 34 to 69 +/- 16 ng per liter in five patients, P less than 0.03; and carboxy-terminal, 1468 +/- 467 to 1083 +/- 402 ml-eq per liter in six patients, P not significant). Although the majority of the patients had transient episodes of asymptomatic hypercalcemia, this complication could be quickly reversed by temporarily halting treatment or decreasing the dose of calcitriol. We conclude that long-term intermittent infusions of intravenous calcitriol are effective in ameliorating osteitis fibrosa in patients on dialysis. Patients whose osteitis fibrosa is refractory to oral calcitriol and who are candidates for parathyroidectomy should be considered first for intravenous calcitriol therapy.
Adult↗
Osteitis pubis in athletes. Infection, inflammation or injury?
Medical records of 59 patients (9 females and 50 males), who presented to sports medicine clinics at the Australian Institute of Sport and the University of British Columbia between 1985 and 1990 and who were diagnosed as suffering osteitis pubis, were reviewed and comparison of data obtained was made with the literature. Women average 35.5 years of age (30 to 59 years) and men 30.3 years (13 to 61 years). Sports most frequently involved were running, soccer, ice hockey and tennis. Clinical presentations of osteitis pubis fell into 4 main groups. 'Mechanical' (sport-related) was the largest group (n = 48), followed by 'obstetric' (n = 5), 'inflammatory' (n = 4) and 'other' (n = 2). Period of follow-up averaged 10.3 months (1 to 20 months) in women and 17.5 months (2 to 96 months) in men. Full recovery, when documented, averaged 9.5 months in men and 7.0 months in women. Osteitis pubis recurred in 25% of these men and none of these women at follow-up. The most frequent symptoms were pubic pain and adductor pain. Men also presented with lower abdominal, hip and perineal or scrotal pain; women with hip pain. Most common signs were tenderness of the pubic symphysis and tenderness of adductor longus muscle origin. Men also revealed tenderness of one or both the superior pubic rami and evidence of decreased hip rotation (unilateral or bilateral). Evidence of pelvic malalignment and/or sacroiliac dysfunction was frequently seen in both men and women. There was poor correlation between radiographic and isotope bone scan findings and the site and duration of symptoms and signs. Femoral head ratios were estimated on 30 hips in the series and 2 were judged to be at the upper limit of normal, perhaps indicating a form of epiphysiolysis producing tilt deformity of the head of the femur. It is clear that osteitis pubis in athletes is not uncommon and that factors such as loss of rotation of hips and previous obstetric history are important in the aetiology and management of this condition. Pelvic infection, which was believed to be the primary factor of osteitis pubis in the literature up until the 1970s, plays a very small role in this condition in athletes.
Adolescent↗
Differential diagnosis between osteitis condensans ilii and sacroiliitis.
Sacroiliitis of seronegative spondyloarthropathy may sometimes show on pelvis plain films findings indistinguishable from those of osteitis condensans ilii. Computed tomography (CT) can differentiate earlier than plain radiography between the 2 conditions; furthermore, it should also be possible to make this differentiation clinically. The aim of our study was to verify whether the criteria recently proposed by the European Spondylarthropathy Study Group (EESG) for the classification of spondyloarthropathy are useful. CT scans through the synovial part of the sacroiliac joints of 7 consecutive patients meeting the ESSG criteria and showing typical findings of osteitis condensans ilii on plain films were mixed with those of 15 consecutive patients with osteitis condensans ilii not meeting the ESSG criteria. Scans were examined for joint space and surface abnormalities blindly and independently by 2 observers. Six patients in the spondyloarthropathy group and one in the osteiitis condensans ilii group showed clear erosions and/or joint space narrowing of less than 2 mm in at least one joint. The difference was statistically significant (p less than 0.001). Our results suggest that by using criteria valid for the whole group of seronegative spondyloarthropathies, it is possible to differentiate clinically between seronegative spondyloarthropathies with sacroiliitis mimicking osteitis condensans ilii and "true" osteitis condensans ilii.
Adult↗
Mechanical stability and post-traumatic osteitis: an experimental evaluation of the relation between infection of bone and internal fixation.
Stable and unstable internal fixation of fractures was performed in rabbits. After inoculation with Staphylococcus aureus, clinically manifest osteitis occurred only in the very unstable fractures. Abscesses, sinuses and sequestra developed in 45 per cent of the unstable fractures, whereas clinically manifest osteitis did not occur after rigid fixation. With rigid fixation there was no significant difference in the time to bony union between the infected and uninfected fractures. It seems that the development of osteitis and the healing of a fracture are both related to the degree of rigidity, but remain independent of each other. The significance of these findings in the management of posttraumatic osteitis is discussed.
Animals↗
Infectious osteitis pubis.
Osteitis pubis is a well-recognized painful inflammation involving the structures of the anterior half of the pelvic girdle, but its cause remains controversial. Biopsy and culture of the pubic bone in 3 patients with osteitis pubis after implantation of a urinary anti-incontinence device were consistent with pubic osteomyelitis which responded to antibiotic therapy. Infection was also found in almost all previously reported cases of osteitis pubis subjected to similar biopsy and culture. Bone biopsy and culture should be strongly considered before initiating frequently unsuccessful empirical therapy in patients with osteitis pubis.
Aged↗
An unusual case of pustulotic arthro-osteitis affecting the leg, and erosive polyarthritis.
Pustulotic arthro-osteitis is a syndrome, originally described in Japan, in which a sterile inflammatory osteitis of the sternoclavicular region occurs in combination with a non-erosive arthritis, sacroiliitis, and a pustulotic rash on the palms and soles. Although the disease has been reported in white populations, it is rarely seen by rheumatologists in the United Kingdom. The case of a Scottish woman is described in whom the diagnosis of pustulotic arthro-osteitis was overlooked because of an atypical site of the disease--the fibula, an erosive arthritis, and absence of a pustular rash at the time of her presentation with musculoskeletal symptoms. This case shows that the syndrome may easily by missed unless clinical suspicion is high and should be considered in any patient with culture negative osteitis, even outside the sternoclavicular region.
Arthritis↗
[Unusual zones of osteitis detected during salvage tympanoplasty].
Three patients were noted to have unusual zones of osteitis during salvage myringoplasty. The first case involved the whole upper wall of the bony canal and was camouflaged by a weeping mucopolypoid carpet. In the second case there was a wide zone of osteitis of the posterosuperior angle of the canal and another smaller zone in the anteroinferior tympanic region. The osteitis in the third case had invaded the total mastoid cortex producing a vast plaque of superficial osteitis which could be removed without difficulty. Diffuse osteomatous reaction of the wall of the canal had resulted. In all three cases a salvage myringoplasty was possible after elimination of the osteitic lesions, although a glue ear persisted with a punctiform perforation in one patient, suggesting tubal dysfunction.
Adult↗
[Etio-pathogenesis of osteitis pubis (author's transl)].
The origination and the further development of an osteitis pubis in an 67-year-old man after the removal of an ureterolith by a Zeiss loop are described. A survey of the relevant literature shows that this is the first case of osteitis pubis after the removal of an ureterolith. The etio-pathogenetic aspects of osteitis pubis are discussed. The therapy of osteitis pubis is mentioned.
Aged↗
Sensorineural deafness due to osteitis fibrosa.
A 91-year-old woman with deafness died from renal failure. Autopsy revealed osteitis fibrosa cystica generalisata, chronic myeloid leukemia, renal atrophy, and hyperplastic parathyroid glands. The temporal bones showed senile osteoporosis, osteitis fibrosa, and chronic myeloid leukemia. The inner ears showed extensive degeneration of cochlear sensorineural elements. The perilymph showed a general increased staining reaction with hematoxylin-eosin that was most evident in localized areas, where marrow spaces of osteitis fibrosa communicated directly with perilymph. It appears that the active diseased marrow exerted a toxic effect on the sensorineural elements of the cochlea by diffusion through the perilymph.
Aged↗
Osteitis fibrosa cystica (brown tumor) of the spine with cord compression: report of a case with needle aspiration biopsy findings.
A case of osteitis fibrosa cystica or brown tumor of bone in a patient presenting with acute spinal cord compression that was suggested initially by needle aspiration biopsy of the spine is described. Following the aspiration biopsy, excision of vertebral lesions, cord decompression, and spinal fusion were successfully performed. A parathyroid adenoma was subsequently identified and also resected. Along with the diagnosis of malignancy, the presence of hyperparathyroidism with osteitis fibrosa cystica should be considered in a patient presenting with lytic lesions in bone, especially if they are associated with hypercalcemia. Serum parathormone level determination is usually diagnostic of hyperparathyroidism, but this test has a 7-10-day turnaround time. Preoperative needle aspiration biopsy is a safe and rapid method of diagnosing osteitis fibrosa cystica and may be of critical importance in a patient with acute and progressive symptoms such as cord compression.
Adenoma↗
Radiation osteitis following irradiation for breast cancer.
Radiographs of the shoulder girdle were examined in 180 women who attended the breast follow-up clinic at the Department of Radiotherapy, Edinburgh. These comprised 52 controls who had been treated by radical mastectomy alone and 128 patients who had received post-operative X-ray therapy. The significance of osteoporosis as a sequel to irradiation is doubtful as it occurred in a substantial proportion of the control cases. Osteitis of severe degree occurred in 13.3% of patients who had been irradiated and was present in a mild form in a further 8.6%. The development of severe osteitis requires an NSD of 1650 rets or more. Estimates of the frequency of radiation osteitis are of no value unless detailed information is also provided about the techniques and quality of radiation.
Aged↗
Condensing osteitis of the clavicle: magnetic resonance imaging as an adjunct method for differential diagnosis.
Condensing osteitis of the clavicle is a benign disorder leading to osteosclerosis of the medial end of the clavicle. The differential diagnosis between condensing osteitis of the clavicle and ischaemic necrosis of the medial clavicular epiphysis (Friedrich's disease), osteoid osteoma, and low grade osteomyelitis can be difficult. In the case history reported here, magnetic resonance imaging was a useful non-invasive procedure for the diagnosis of condensing osteitis of the clavicle.
Adult↗
Proliferative osteitis of the femoral greater trochanter and humeral medial epicondyle as a cause of lameness in sows.
Thirteen chronically lame female breeding pigs were examined clinically and post mortem. Of the eight sows with hindleg lameness, one showed detachment of the ischial tuberosity and a second showed detachment of the ischial tuberosity on the left and a mid-shaft femoral fracture on the right. Two showed no lesions apart from a change in the positional relationship between the femoral head and the greater trochanter, resulting in a lowering of the femoral head. In the remaining four sows an apparently unreported condition was seen, which produced a proliferative osteitis of the greater trochanter. All five animals lame in the forelimb showed varying degrees of proliferative osteitis of the medial epicondyle of the humerus. Advanced cases could be palpated in the live animal. It is proposed that proliferative osteitis may be a response, at the point of attachment of the muscle masses of the major limbs, to the trauma of over exertion.
Animals↗
Condensing osteitis of the clavicle: does it exist?
Condensing osteitis of the clavicle was first described as a disease entity in 1974. There is painful localised swelling of the clavicle of undetermined origin, with increased radio-density, but an infective aetiology has not been excluded by previous authors. We report three children with the clinical and radiological findings of 'condensing osteitis'. Two of them had raised levels of antistaphylolysin titres and all responded to antibiotic therapy. We conclude that condensing osteitis is due to low-grade staphylococcal osteomyelitis; biopsy and treatment by antibiotics is recommended.
Anti-Bacterial Agents↗