Sharp periostit – an acute inflammation of a periosteum. Results from contact or hematogenic transfer of an infection. Develops owing to injuries or inflammatory diseases of surrounding fabrics more often. A diaphysis of long tubular bones (hips, are more rare – a shoulder and a shin) and edges can be surprised. The most widespread is periostit jaws, in life this kind of a disease is called gumboil. It is shown by pain, hypostasis and temperature increase. It is diagnosed on the basis of complaints and data of survey. Treatment in the absence of a purulent inflammation conservative. At suppuration operation is necessary.
Sharp periostit (Latin peri-around, near + osteon a bone) – sharp inflammatory process in a periosteum. It is usually provoked by stafilokokka and streptococci. In bones of a trunk and extremities, as a rule, arises after a trauma or at an inflammation of surrounding soft fabrics. Sharp periostit jaws is a periodontitis complication more often though can arise also at difficulty of a teething or the wrong treatment of caries, a pulpitis, periodontitis. The periosteum is closely tied with a bone therefore periostit often is complicated by an inflammation of a bone tissue and development of an osteoperiostit.
The isolated sharp periostit bones of extremities and trunks meets rather seldom; traumatologists and orthopedists are engaged in treatment of this form of a disease. Periostit jaws is widespread pathology, it is mainly observed at young people and people of middle age; treatment is performed by stomatologists.
Pathogenesis of a sharp periostit
Penetration of microbes into a periosteum causes inflammatory reaction. The periosteum becomes edematous, full-blooded and exfoliates from a bone. Between a bone and an otsloyenny periosteum inflammatory serous liquid accumulates. At further progressing of a disease the inflammatory centers inclined to merge filled with liquid are formed. Suppuration of liquid and merge of the centers of an inflammation becomes the reason of formation of podnadkostnichny abscesses.
If at this stage opening and drainage, pus is not made or begins to extend deep into bones, causing osteoperiostit, or breaks outside, forming paraossalny phlegmon. In the subsequent in the first case development of secondary osteomyelitis is possible. In the second case at favorable option of succession of events the abscess is spontaneously opened, at adverse - the infection continues to extend on soft fabrics, affecting muscles and sinews and forming flow.
Sharp periostit bones of a trunk and extremities
The most common form of a disease is idle time aseptic periostit. Usually arises after a bruise, it is localized in the places insufficiently "covered" with soft fabrics: external department of a shoulder, disteel external department of a beam bone, proximal back department of an elbow bone, forward department of a tibial bone. It is shown by spontaneous pains and pains at palpation, moderate or insignificant hypostasis of soft fabrics and a small focal eminence in a bone. Less often idle time periostit is observed at dystrophic processes in circumarticular fabrics (to a stiloidita, you epikondilit). Changes on roentgenograms are absent. Treatment is conservative: NPVS warming compresses, UVCh, an electrophoresis with calcium chloride, novocaine and a hydrocortisone.
Sharp purulent periostit, as a rule, develops at a direct injury of a periosteum (for example, at a deep wound with damage of an external layer of a bone) or upon transition of an infection from surrounding fabrics (at purulent wounds, an erysipelatous inflammation, phlegmon, abscesses etc.). In the isolated look meets seldom. More often is a part of more widespread purulent process – sharp hematogenic, traumatic or contact osteomyelitis.
Is followed by sharp pains, considerable hypostasis of soft fabrics, temperature increase of a body and symptoms of the general intoxication. In the field of defeat the wide bugristost, sharply painful is probed at a palpation. When carrying out a X-ray analysis at initial stages of change are absent. In the subsequent the periosteum thickening is defined, upon transition of an inflammation to a bone symptoms of osteomyelitis come to light. Treatment – opening of paraossalny phlegmons or podnadkostnichny abscesses against the background of antibiotic treatment and the all-strengthening actions.
At timely treatment the forecast at all types of a periostit favorable. At a simple form of a disease all symptoms, as a rule, disappear within 5-6 days. At purulent defeat recovery can borrow from several weeks to several months. In some cases (especially in the absence of treatment) transition of a sharp periostit in chronic or development of heavy purulent complications is possible.
Sharp periostit jaws
Arises in the lower jaw more often. Any tooth can become a source of an infection, but, as a rule, the inflammation passes to a periosteum from big molars. The most common cause of emergence of a sharp periostit – periodontitis, less often an inflammation passes to a periosteum at infection of wounds from the extracted teeth, the wrong dental care or an inflammation of the impacted teeth. Usually inflammatory process begins in the field of a root. At preservation of outflow through a gum or channels of tooth perhaps spontaneous healing, at outflow violation – spread of an infection on the subject bone.
At a sharp purulent periostit the intensive, sometimes pulsing pains are observed, it is frequent – with irradiation to the area of an eye, temple and ear. At contact with warm food or liquid pain amplifies, at contact with cold – decreases. Temperature increase is possible (usually insignificant). The severe toothache in combination with symptoms of the general intoxication is characteristic of a diffusion sharp periostit: temperature increase to subfebrilny figures, weakness, an indisposition and loss of appetite. Hypostasis of soft fabrics which localization depends on an arrangement of affected tooth is observed. At defeat of premolyar there is a puffiness of the lower part of a cheek, painters – the top part of a cheek, is closer to an ear and a cheekbone, the top cutters – parts of a nose and an upper lip.
The diagnosis is exposed on the basis of clinical signs. The X-ray analysis is not informative as signs of an inflammation of a periost become visible not earlier than in 1-2 weeks from the beginning of a disease. Treatment depends on expressiveness and a type of a sharp periostit. At an acute serous inflammation are usually limited to removal of a nerve, wash out a wound solutions of antibiotics and anti-septic tanks. At a purulent periostit in addition use physiotherapy. To patients appoint the antibacterial medicines all-strengthening (vitamins, calcium) and antiallergic means. When progressing process the painful tooth is extracted, the wound is washed out and drained. The forecast is usually favorable.