Ultrasound Features of the Normal and Pathologic Periosteum

Abstract

Thickening and elevation of the periosteum from the underlying bone cortex, defined as a periosteal reaction, can be associated with several bone disorders. Although ultrasound (US) has limited possibilities in assessing bones, it can depict a periosteal reaction earlier than plain radiography, thus indicating underlying bone disorders. This pictorial essay aims to illustrate the normal and pathologic US appearances of the periosteum in both children and adults. Several disorders are discussed, such as pediatric bone trauma, infections and tumors, as well as trauma, overuse, including medial tibial stress syndrome, and finally certain seronegative spondyloarthropathies in adults. Whenever US depicts a periosteal reaction, a correlation with clinical and laboratory data is mandatory to differentiate different bone disorders. Computed tomography or magnetic resonance imaging must be performed when an infection or a tumor is suspected based on both US and the clinical presentation.

Preliminary image findings of lower limb stress fractures to aid ultrasonographic diagnoses: A systematic review and narrative synthesis

“…Lower limb stress fractures are known to mimic acute osteomyelitis and skeletal malignancies (Ewing's sarcoma, osteosarcoma, myeloma, and metastatic neuroblastoma), with all periosteal reactions appearing as hyperechoic raised lines on ultrasound. 28,29 Therefore, radiographic imaging remains crucial to rule out a diagnosis in patients with a suspected stress fracture.…”

“…31 An imaging protocol that distinguishes between these differential diagnoses must be developed to reduce the need for radiographic imaging. 28,29 By identifying key differences between clinical and ultrasonographic presentations, confident diagnoses may be made without risking false negatives. For example, osteomyelitis is typically associated with a fever, and an osteosarcoma is visualised by its 'sunburst' appearing periosteal reaction using ultrasonography.…”

“…For example, osteomyelitis is typically associated with a fever, and an osteosarcoma is visualised by its 'sunburst' appearing periosteal reaction using ultrasonography. 28 To initiate an interest in research, this systematic review collated secondary data, since it is inexpensive, fast and encompasses a large sample size. 33,34 Future research regarding appearances of stress fractures using ultrasound for early medical intervention requires the collaboration of primary data alongside this systematic review to assess external validity of the results.…”

Possibilities of instrumental diagnostic methods for visualizing the pubic periosteum in the femoral canal

“…Что касается УЗИ, то в исследовании А.D. Moraux et al (2019), посвященном надкостнице у детей и взрослых, показано, что нормальная надкостница едва видна при УЗИ здоровых людей. При этом доплеровский сигнал не фиксируется, но может быть видна питающая кость артерия.…”

Options for the treatment of the femoral hernia with atrophy of the public bone in the formed femoral canal

“…Забор же материала во время операций для морфологического исследования (биопсия кости с надкостницей) нами признан этически невозможным, так как требует выполнения трепанации лонной кости, что повышает травму вмешательства при выполнении операции и риск возможных осложнений. Визуализация надкостницы лонной кости с помощью УЗИ и КТ оказалась невозможной, так как у взрослых она не определяется [13][14][15][16][17][18].…”