Physiologic periostitis describes the normal presence of smooth bilateral diaphyseal periosteal new bone in the humeri, femora, or tibiae of infants aged 1 to 6 months. It can be observed in both preterm and term infants. The etiology is unclear but may simply relate to rapid growth.
Radiographic features
long bones: tibiae, humeri, and femora relatively equally affected
diaphyseal smooth periosteal reaction which may extend partly into the metaphyseal region, but not to the end of the metaphysis
always bilateral and usually symmetric in extent
organized and lamellar 2
often concentric around the bone but may predominate on one aspect
when tibial, it is always seen along the medial aspect
no fracture or metaphyseal corner lucency
no flat bone involvement
Nuclear medicine
Bone scan
Normal uptake is observed. In contrast, there is high uptake in trauma 2.
Differential diagnosis
trauma / non-accidental injury: asymmetric, lucent fracture line, soft-tissue swelling
osteomyelitis: asymmetric, usually metaphyseal, soft-tissue swelling
Caffey disease (infantile cortical hyperostosis): same age group, flat bone involvement, soft-tissue swelling
Unable to process the form. Check for errors and try again.