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PubMed1985

[Early diffuse hypertrophic osteitis recurrence. Unexpected and consternating development after a large évidement cavity. Apropos of 15 cases].

The authors report 15 cases collected over a period of 13 years (1972 - 1984) of a particularly serious eventuality affecting certain evacuation cavities: Early recurrence of diffuse hypertrophic osteitis (E.R.D.H.O.). This is a rare complication, occurring in 1.5% of cases of chronic otitis. However, the fact of having operated upon 7 cases in 1984 alone, whilst during the previous 12 years, only 8 had been seen, raised the alarm. The classical pattern of this complication occurs in 3 stages, each involving surgical operation: at the outset, chronic otitis with cholesteatoma or osteitis, most often mixed, for which an "inadequate" surgical procedure is performed. then, after a variable period which may exceed 10 years, a very large evacuation cavity was created by the authors. finally, 3rd and final stage: within 6 months, this cavity filled progressively and, at operation, the authors discovered a cavity virtually completely filled with a "fantastic" "moist sugar" osteitis, requiring a new evacuation cavity, even larger than that created before. In all cases, a successful result was obtained within a varying period, sometimes accompanied by spectacular improvement in general condition. The most plausible etiopathogenic hypothesis advanced to attempt to explain this phenomenon is that of secondary infection by a varied microbial flora, including, on the one hand, aerobic organisms usually discovered in such cases (pseudomonas pyocyaneus, proteus mirabilis) and, secondly, this being of essential importance, "anaerobic" bacteria, the bacteriological diagnosis of which requires application of a strict protocol. The authors have taken three decisions following their bibliographic investigations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Therapeutic management of fracture-induced osteitis].

Fractural osteitis is considered to be exclusively of external origin, being due either to accidental wounds, or to operatory wounds. The infection is usually either with a single strain of germs, or with a small number of strains, most frequently a staphylococcus strain with a necrototizing effect on the bone structure. The prophylaxis has a determinant role, and the authors stress the organisatory measures, as well as the medical attitudes that should prevail in the face of an open fracture. In the case of closed fractures that have been infected as a result of surgery the necessity for an "early reintervention" is stressed. Late postoperative osteitis may develop in a consolidated focus, and is called osteitis of the repaired bone. It may also develop as an osteoarthritis or, and this is more serious, as a suppurated pseudarthrosis. The therapeutic attitude depends on the condition, and may consist in the removal of the osteosynthesis material, removal of the sequestered bone tissue, a so-called: "mis-à-plat" of the cavity with muscular tissue and application of septopal pearls, or a two-stage spongious graft according to Papineau, under protection of the external fixation when the necessity arises.

Fracture Fixation↗
PubMed1981

[Pubic and ischio-pubic osteitis. Bacteriological and histopathological study of the pubic bone].

The authors present 11 cases of pubic or ischio-pubic osteitis of which ten had undergone bone biopsy by aspiration, needle biopsy, or surgery. In 7 cases, a germ was isolated by culture of the bone sample. In 2 cases, there were purulent and necrotic lesions on pathological examination of the fragment. In 6 cases, the bony lesions were mainly of the marrow with fibrosis and lymphocyte-plasma cell infiltration. In 5 of these 6 biopsies, the bacterial culture was positive. This subacute mononuclear osteitis may thus be a variety of bacterial osteitis. All the patients were treated with antibiotics which seemed necessary.

Adult↗
PubMedDate not supplied

Osteitis pubis.

BACKGROUND: A 55-year-old woman was seen for pubic symphysis tenderness that started 3 weeks after bladder suspension surgery for urinary incontinence. A diagnosis of osteitis pubis was made based on the results of the physical, radiographic, and laboratory examinations. The paucity of information on this topic in primary care textbooks prompted a literature review of the subject. METHODS: A computer-assisted literature search of the MEDLINE files from 1966 to the present was performed using the terms "osteitis," "osteomyelitis," and "pubic symphysis." Older documents and papers of related interest were obtained by cross-reference of the bibliographies of the articles generated by the search. RESULTS AND CONCLUSIONS: Osteitis pubis is an infrequent complication of pelvic surgery, parturition, or athletic activities. The diagnosis is made on the basis of the typical findings of pubic tenderness and pain on hip abduction that occurs a few weeks following the inciting event. Initial treatment consists of rest, physical therapy, and oral nonsteroidal or glucocorticoid anti-inflammatory medications. The use of intra-articular glucocorticoid injections is controversial. Surgery is rarely indicated and should be reserved for patients who have severe pain or pubic instability that has not responded to conservative therapy.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1992

Alveolar osteitis after surgical removal of impacted mandibular third molars. Identification of the patient at risk.

One hundred thirty-eight impacted mandibular third molars were surgically removed. A prospective study of risk factors associated with the development of alveolar osteitis (dry socket) postoperatively was undertaken. Two surgeons, one experienced and one inexperienced, removed the teeth. Patients were controlled for age, sex, use of oral contraceptives, radiographic difficulty of the extraction, and tobacco use. Patients treated by the inexperienced surgeon and those using tobacco had a significantly greater incidence of alveolar osteitis. Previously identified risk factors of increased age, female sex, oral contraceptive use, and increased surgical time were not associated with an increased incidence of dry socket. Recommendations are made regarding prevention of alveolar osteitis in those patients identified as being at high risk.

Adolescent↗
PubMed1987

The effect of tetracycline on the incidence of postextraction alveolar osteitis.

Four hundred twenty-four mandibular third molar extractions of varied surgical difficulty were evaluated for the occurrence of alveolar osteitis. In 219 of these sockets, tetracycline powder was placed immediately after the tooth was removed. This resulted in a significant reduction in the incidence of alveolar osteitis from 28.7% to 14.6%. There was also a positive correlation between the rate of alveolar osteitis and the increasing depth of the impaction and the degree of surgical difficulty.

Dexamethasone↗
PubMed1990

Effects of a chlorhexidine gluconate oral rinse on the incidence of alveolar osteitis in mandibular third molar surgery.

Alveolar osteitis (dry socket) continues to be a frequent sequela of third molar surgery. Chlorhexidine 0.12% used as an oral rinse has been reported to reduce the incidence of dry socket. This study compares the effectiveness of 0.12% chlorhexidine used as a preoperative rinse and immediate postextraction irrigant with 1) similarly used 0.05% cetylpyridium, preoperative chlorhexidine rinse and postextraction saline irrigation, and 2) only postextraction irrigation with normal saline in the reduction of alveolar osteitis in mandibular third molar extractions. The results indicate that chlorhexidine and cetylpyridium were no more effective in the reduction of alveolar osteitis than postextraction irrigation with normal saline.

Adolescent↗
PubMed1991

The effect of a chlorhexidine rinse on the incidence of alveolar osteitis following the surgical removal of impacted mandibular third molars.

A prospective randomized double-blind placebo-controlled study was conducted with 139 patients (278 bilaterally impacted mandibular third molars) to determine the effect of a perioperative 0.12% chlorhexidine gluconate rinse on the incidence of alveolar osteitis following surgical removal of impacted mandibular third molars. A statistically significant 60% reduction in the incidence of alveolar osteitis was obtained in the chlorhexidine group compared with the placebo group. In most subgroups analyzed, chlorhexidine was associated with at least a 50% reduction in alveolar osteitis compared with control groups.

Adolescent↗
PubMed1995

Evaluation of topical viscous 2% lidocaine jelly as an adjunct during the management of alveolar osteitis.

PURPOSE: This study evaluated the efficacy of topical viscous 2% lidocaine jelly for the alleviation of pain experienced during the instrumentation of mandibular third molar extraction sites diagnosed with alveolar osteitis and for pain relief during the postinstrumentation period. PATIENTS AND METHODS: Thirty adult patients with a diagnosis of alveolar osteitis in a mandibular third molar extraction site were included in this prospective, double-blind study. Each patient had their sutures removed, the socket irrigated, and 2% lidocaine jelly placed on the tip and side of the tongue to blind the patient against the test substances. The subjects were then randomly distributed into two groups. Group 1 had a nonactive jelly base placed into the socket 2 minutes prior to the placement of a standard obtundant dressing. Group 2 had viscous 2% lidocaine jelly placed into the socket in the same manner. Patients subjectively quantified their pain intensity pretreatment, during instrumentation, immediately postmanipulation, at 5-minute intervals to 30 minutes, and at 45 and 60 minutes. They also subjectively quantified their pain relief at each of the time intervals following instrumentation. RESULTS: There was no statistical difference between the pretreatment pain experienced by both groups. The use of 2% lidocaine jelly had a measurable (P = .056), but not statistically significant, effect on pain due to instrumentation. At every time interval thereafter, the use of 2% lidocaine jelly elicited a statistically significant (P < .05) decrease in pain perception, and a statistically significant increase in pain relief when compared with the inactive jelly. CONCLUSION: Topical viscous 2% lidocaine jelly is a useful adjunct during the treatment of alveolar osteitis, especially in the early (< or = 60 minutes) postinstrumentation period.

Adult↗
PubMed2001

Pustulotic arthro-osteitis: defining the radiologic spectrum of the disease.

Pustulotic arthro-osteitis (PAO) was termed by Sonozaki et al., who discussed the relationship between palmoplantar pustulosis (PPP) and osteoarticular inflammation. Manifestations of PAO are observed in the anterior chest wall, the spine, the pelvis, the sacroiliac joint, and the long bones. Hyperostosis is a radiological feature of PAO; furthermore, anterior chest wall involvement is common. The term SAPHO syndrome (SAPHO being an acronym for synovitis, acne, pustulosis, hypertostosis, and osteitis) has been coined to describe disease that manifests sterile inflammatory bone lesions together with skin eruptions. SAPHO syndrome groups together the following osteo-articular lesions that have been described as separate medical entities: chronic recurrent multifocal osteomyelitis (CRMO), PAO, and arthro-osteitis associated with a follicular occlusive triad. Osseous changes due to psoriasis vulgaris and generalized pustular psoriasis can be radiologically and clinically distinguishable from osseous changes due to PPP, acne, and CRMO as seronegative spondyloarthropathies.

Acquired Hyperostosis Syndrome↗
PubMed1998

Four cases of pustulotic arthro-osteitis.

We describe four cases of pustulotic arthro-osteitis. All of them suffered from anterior chest wall symptoms, such as swelling and pain on the sternoclavicular joint, sternal angle area, sternocostal joint, and costochondral junction. Although chest X-ray findings were all normal, 99mTc-scintigraphy revealed increased uptake in the affected areas in all cases. Laboratory examinations including rheumatoid factor were negative or normal except for elevation of the erythrocyte sedimentation rate and C-reactive protein in 2 cases. After treatment with non-steroidal anti-inflammatory drugs and etretinate or topical PUVA, the skin lesions on the palms and soles and the arthro-osteitis were moderately improved. Pustulotic arthro-osteitis should be considered when a patient with pustulosis palmoplantaris complains of anterior chest wall pain and other joint pain.

Adult↗
PubMed2005

Osteitis pubis: an important pain generator in women with lower pelvic or abdominal pain: a case report and literature review.

BACKGROUND: Osteitis pubis is an aseptic painful inflammatory condition of the symphysis pubis, surrounding muscles, and tendons. It was first described in 1924 in patients who had suprapubic surgery. Inflammation and trauma have been attributed to be causative factors in previous individual case reports and small case series. Osteitis pubis is frequently misdiagnosed and is difficult to treat once it becomes chronic. RESULTS AND CONCLUSION: Osteitis pubis is often a missed entity although pelvic x-ray, scintigraphy, or a diagnostic/therapeutic steroid and anesthetic injection into the symphyseal plate can be implemented to diagnose and treat it.

Journal Article↗
PubMed2000

Evolution of chronic recurrent multifocal osteitis toward spondylarthropathy over the long term.

OBJECTIVE: To retrospectively assess, with a sufficiently long followup (mean 11.6 years; median 9 years), the long-term outcome of chronic recurrent multifocal osteitis (CRMO), a multifocal, inflammatory bone disease. METHODS: Patients included were 8 children/adolescents and 7 adults with no family history of rheumatic disease who had been diagnosed as having CRMO between 1979 and 1995. Ten patients had undergone at least 1 bone biopsy of the lesions, with histologic examination and multiple cultures. In 1996, in addition to an in-depth interview, 12 patients underwent an extensive physical examination, laboratory evaluation, HLA-A, B, C, and DR typing, bone radiography and scintigraphy, and computed tomography scan of the sternoclavicular and sacroiliac joints. RESULTS: Remission was observed in 3 patients. The other 12 patients developed various associations of vertebral (n = 10), sacroiliac (n = 6), anterior thoracic (n = 7), peripheral articular (n = 2), enthesopathic (n = 4), or dermatologic (palmoplantar pustulosis in 3 cases and psoriasis in 2) involvements. Spine involvement was the most common and occurred the earliest (median time to appearance after the onset of osteitis 5.63 years). Clinical sacroiliitis was always unilateral. No patients carried the HLA-B27 haplotype. CRMO responded well to nonsteroidal antiinflammatory drugs. Twelve patients met the European Spondylarthropathy Study Group criteria for spondylarthopathy. CONCLUSION: After 10 years, CRMO had usually evolved to spondylarthropathy, but with certain features not usually seen in the latter: predominantly, unilateral sacroiliitis, no familial form, and no link with HLA-B27.

Acute Disease↗
PubMed1990

Outbreak of spontaneous staphylococcal arthritis and osteitis in mice.

Staphylococcus aureus is the most common bacterial species found in association with nongonococcal bacterial arthritis in humans. We present here the first description of spontaneous bacterial arthritis and osteitis in mice. Clinically, the most obvious findings were swelling and/or ankylosis of hindpaws and nodose changes of the tail. The prevalence of arthritis and osteitis ranged from 0% to greater than 50% of the mice studied, depending on the mouse strain. The most prominent histopathologic feature of the arthritis was hypertrophy of the synovial tissue and destruction of cartilage and underlying bone. Most of the S aureus-infected mice displayed an identical phage type, which was also the only S aureus phage type found in skin isolates from clinically healthy mice. However, a few S aureus isolates were not typeable, indicating that an additional strain(s) might cause bacterial arthritis in mice.

Animals↗
PubMedDate not supplied

Fine needle aspiration of osteitis fibrosa cystica.

The cytology findings of a fine needle aspiration biopsy from osteitis fibrosa cystica (brown tumor) of the rib in a patient with primary hyperparathyroidism due to parathyroid carcinoma are discussed. Many multinucleated osteoclast-type giant cells, characteristic of either osteitis fibrosa cystica or benign giant cell tumor of bone, were noted. There were also spindly or fibrillary cells with single, ovoid nuclei, probably of stromal origin.

Aged↗
PubMed1993

Pseudohypoparathyroidism with osteitis fibrosa cystica: direct demonstration of skeletal responsiveness to parathyroid hormone in cells cultured from bone.

A young girl had tibial osteotomies at age 14 for genu valgum and then had recurrent tibial cysts over a number of years. Hypocalcemia and hyperphosphatemia were first noted at age 21. The diagnosis of pseudohypoparathyroidism was made at age 28, when elevated plasma PTH was detected. Clinical and biochemical features, including a PTH response test and assay of RBC Gs, established the diagnosis of pseudohypoparathyroidism type 1b. Failure to suppress plasma PTH with vitamin D therapy led to an exacerbation of her cystic bone disease; there were widespread lytic lesions radiologically, most of which took up [99mTc]diphosphonate on bone scan. Microradioscopy revealed evidence of resorption of phalangeal tufts. Bone biopsy showed osteitis fibrosa cystica. During an orthopedic procedure, trabecular bone fragments were taken from her right humerus, and bone-derived cells cultured using an explant technique. The cultured cells were osteoblast-like in morphology, fully responsive to PTH, cholera toxin, forskolin, and PGE1 in vitro, and had an alkaline phosphatase and osteocalcin response to 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3]. Following this examination of skeletal responsiveness, attempts were made to suppress the elevated plasma PTH levels and symptomatic bone disease by optimizing therapy with oral 1,25-(OH)2D3. When bone pain associated with the cystic bone disease failed to resolve, the patient underwent total parathyroidectomy, following which the bone pain gradually resolved. This is the first direct demonstration of PTH responsiveness in cultured bone cells in the syndrome of pseudohypoparathyroidism with osteitis fibrosa cystica.

Adenylyl Cyclases↗
PubMed1990

Case report 623. Osteitis condensans of the left clavicle (OCC).

A case of OCC in a 35-year-old woman is presented. Proof was obtained by open biopsy. This rare entity is benign and its etiology is still obscure. No definite association with osteitis pubis or osteitis condensans ilii has been reported. The involvement of the clavicle is invariably unilateral. The clinical and radiographic characteristics of this benign condition have been discussed and the differential diagnosis has been considered. Consideration should be given to the concept that if the imaging features are characteristic, as in this case, biopsy may not be necessary.

Adult↗
PubMed1993

Paraplegia due to osteitis fibrosa secondary to primary hyperparathyroidism: report of a case.

A case of primary hyperparathyroidism associated with osteitis fibrosa cystica presenting as paraplegia is described herein. The symptom complex of normocalcemic hyperparathyroidism with osteitis fibrosa cystica is a distinctly rare entity and to the best of our knowledge, this is the first case report of the normocalcemic variant of primary hyperparathyroidism presenting with paraplegia as a complication.

Adult↗