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At least 19 recordsLinked to original sources
PubMed1985

Periosteal chondroma and periosteal chondrosarcoma.

A clinicopathologic study of 46 patients with periosteal chondroma and 14 patients with periosteal chondrosarcoma revealed that periosteal chondroma tended to affect younger patients and that the lesion was usually smaller. Radiographically, the typical periosteal chondroma was a small, well-marginated tumor on the outer surface of a long bone. Erosion of the cortical surface and marginal buttresses were usually present. Periosteal chondrosarcoma had a more aggressive appearance and was seen as a large mass located superficially on the cortex; the margins of the mass were more irregular than those of chondroma. Histologically, periosteal chondroma frequently showed hypercellularity, plump nuclei, and binucleation. Thus, the differentiation of chondroma from chondrosarcoma is difficult and is based mainly on evidence of invasion. The prognosis in periosteal chondroma is good: only one patient had a local recurrence, none of the tumors underwent malignant change, and excision seems to be curative. However, the prognosis in periosteal chondrosarcoma is not as good: two patients died of metastasis to the lungs after local excision and two patients had recurrences after local resection. Periosteal chondrosarcoma should be treated more aggressively than periosteal chondroma.

Adolescent↗
PubMed1982

Periosteal chondrosarcoma and periosteal osteosarcoma. Two distinct entities.

This review of 27 cases serves to emphasis that periosteal chondrosarcoma and periosteal osteosarcoma are two distinct entities. Clinically, periosteal chondrosarcoma is less painful than periosteal osteosarcoma and runs a slower course. Radiographically, periosteal chondrosarcoma tends to affect the metaphysis and contains granular or "popcorn" opacities; while periosteal osteosarcoma more often affects the mid-diaphysis and shows lytic lesions with some spicules of reactive bone perpendicular to the underlying cortex. Histologically, periosteal chondrosarcoma shows lobular well-differentiated cartilage with Grade I or II (rarely Grade III) malignancy; periosteal osteosarcoma has a chondroid matrix with some osteoid component and Grade II or III malignancy. The prognosis in periosteal chondrosarcoma is good; conservative surgery is usually effective and metastases are very uncommon. In periosteal osteosarcoma the prognosis is less satisfactory but is better than that of other osteosarcomata; wide surgical excision is, however, needed and the incidence of metastases is about 15 per cent.

Adolescent↗
PubMed1978

Premature fusion of facial sutures with free periosteal grafts. An experimental study with special reference to bone formation with free periosteal grafts from the tibia, the scapula and the calvarium.

The present study was undertaken to obtain more information on the bone forming mechanisms with free periosteal grafts and to study premature synostosis of facial sutures achieved with free periosteal grafts. The results are based on a material of 196 rabbits operated on at the age of two weeks. It was found that the bone forming mechanism with free periosteal grafts from the tibia, the scapula and the calvarium is essentially the same. When implanted in the tibialis anterior muscle of the leg of the same animal they all produced bone. The mechanism of bone formation is reminiscent of the enchondral bone formation seen in fracture healing. There is no difference in the bone forming mechanism with the periosteum from an enchondrally ossifying bone when compared with the periosteum of an intramembranously ossifying bone. In all the three different periosteal grafts studied, there was a cartilage stage before bone formation. In the muscle, all these three periosteal grafts, in spite of their tubular or membranous bone origin, produced bones tubular in shape. When the transplants were overlying the membranaceous facial bones, membrane shaped bone developed via intramembraneceous type of ossification in the recipient area. It can be concluded from these experiments that the shape and type of bone developed with free periosteal grafts depends mainly on the environmental conditions in the recipient area. Fusion of the premaxillo-maxillary and fronto-nasal sutures was achieved with free periosteal grafts from the tibia. Free periosteal grafts from the scapula and the calvarium failed to develop premature fusion of the sutures. The fusion developed due to increased bone formation in the suture area. The fusion of the premaxillo-maxillary suture stopped the growth in this area and caused a severe growth disturbance of the whole snout. The fusion of the fronto-nasal suture by the bone bridge retarded the growth of the nasal bone on the fused side and led to deviation of the snout to the operated side. Compensatory changes developed in other sites of the cranio-facial skeleton in order to minimize the effects of the growth disturbance. The fused fronto-nasal suture was used as a model to study the treatment of premature synostosis of facial bones. Resection of the fused area led to correction of the developed growth disturbance and to subsequent normal growth of the snout.

Animals↗
PubMed1982

Microvascular free bone transfer with revascularization of the medullary and periosteal circulation or the periosteal circulation alone. A comparative experimental study.

UNLABELLED: Two different types of vascularized rib grafts presently are used in clinical practice and as experimental models for investigations on free microvascular bone transfer: the posterior rib graft, including both medullary and periosteal blood supply to the bone; and the posterolateral segmental rib graft, supplied by periosteal vessels alone, Complete survival of bone after successful revascularization of the posterior type of graft is well established, but this graft has the disadvantage of a complicated dorsal dissection which has limited its clinical use. Instead, many microsurgeons have utilized the posterolateral rib segment, which is easy and safe to excise although its viability and adequate microcirculation have not yet been confirmed. In nine large dogs, we compared the viability and vascularity of bone after transfer of the two types of bone grafts by histological methods, fluorochrome bone-labeling, microangiography, and technetium scintigraphy. The grafts were transferred to the subcutaneous fat tissue in the groin, where blood supply was reconstituted by microvascular anastomoses to local donor vessels. The results suggest that a bone transplant with revascularization of periosteal only established a collateral circulation to medullary vessels, and that there is no difference in viability of the two kinds of grafts. CLINICAL RELEVANCE: The technique of transferring whole bone segments by microvascular anastomoses of their vascular pedicles has been employed clinically either by preserving the periosteal blood supply alone or by preserving the medullary and the periosteal blood supply. This study demonstrates that the preservation of the periosteal blood supply alone can result in complete bone-graft survival even when the graft is placed in a poorly vascularized tissue bed.

Animals↗
PubMed1989

Experimental study of free periosteal autograft. Animals age and periosteal osteogenesis.

This is a study of the correlation between the age of animals and the osteogenic potential of free periosteal autograft. The tibial periosteum of 27 rabbits, ranging in age from 4-104 weeks, was stripped and implanted into the quadriceps. Radiographic and histologic examination demonstrated that new bone was formed in both the young and adult rabbits. The morphologic basis and mechanism of bone formation of periosteum are discussed. Maintenance of integrity of the cambium layer of the periosteal graft is emphasized. Free periosteal graft of adult rabbits in the "resting" state can retain its osteogenic potential and produce new bone.

Aging↗
PubMed1986

Periosteal resorption and periosteal neostosis: comparison of normal subjects and renal failure patients on chronic ambulatory peritoneal dialysis using MOP-3 image analysis system and a grading method.

This is the first known attempt to quantitate periosteal resorption (PR) and perisoteal neostosis (PN) by a semi-automatic image analysis system (Zeiss MOP-3). The normal ranges and errors for PR were found to be similar to those of a previous study using a measuring magnifier. The findings in chronic renal failure patients showed that MOP-3 measurements were actually diagnostically slightly less sensitive than the results by a simple grading method. Comparison with plasma-immunoreactive parathyroid hormone (iPTH) concentrations showed that while the latter had a higher sensitivity for detection of hyperparathyroidism, the radiologic parameters nevertheless showed abnormal PR in 12% of the observations where iPTH was normal. Both PR and PN correlated significantly with iPTH (r = 0.55 and 0.30 respectively, P less than 0.01).

Adult↗
PubMed1982

Periosteal transection and periosteal stripping for correction of angular limb deformities in foals.

Valgus deformities were created in 6 pony foals by hemicircumferential transection of the periosteum and periosteal stripping (HCTP and PS) just proximally to the distal physis on the medial side of 1 radius (principal thoracic limb). The opposite thoracic limb served as a control. One month after this surgical procedure was done, the limbs were radiographed and the angle of deviation was determined. All horses developed a valgus deformity of the principal limb. In an effort to correct the acquired valgus deformity, the 2nd surgical procedure was performed--HCTP and PS on the lateral aspect of the principal radius. The carpal valgus deformities corrected within 3 months. To determine the differences in growth, stainless steel wires were introduced into both legs of each foal at certain points on the distal part of the radius. Growth changes in response to the HCTP and PS were not significantly different in the 2 groups of thoracic limbs. Increased bone growth did occur at the medial aspect of the bone in response to the 1st surgical procedure and an increase was found on the lateral aspect of the bone in response to the 2nd. The reasons for the statistically insignificant changes are discussed. A significant increase in bone width at the level of growth plate developed in response to the 1st and 2nd HCTP and PS procedures.

Animals↗
PubMed1977

[Periostitis or, rather, periosteal appositions in paediatrics (author's transl)].

In relation to a case of multiple fatigue fractures definitely diagnosed by scintigraphy and xerography, the authors report two other previous cases of spontaneous fractures at a single site in which the diagnosis was made only after surgical biopsy and histological examination. Recalling the frequent confusion arising in children between periosteal appositions and osteomyelitis or Ewing's sarcoma, and the different radiological phases of this type of fracture, they stress the necessity for a maximum effort to demonstrate the key element in the diagnosis: the cortical fissure. The latter is often minimal, at the limit of visibility and developing late. Thus repeated examinations and the use of special radiological techniques are necessary.

Bone Diseases↗
PubMed1991

Magnetic resonance imaging detection of early experimental periostitis. Comparison of magnetic resonance imaging, computed tomography, and plain radiography with histopathologic correlation.

This study characterizes the appearance of periosteal reaction by magnetic resonance imaging (MRI), and evaluates the efficacy of MRI versus computed tomography (CT), and plain film radiography (PF) in detecting early, experimentally induced periostitis. Acute Staphylococcus aureus osteomyelitis was induced in 30 legs of 20 New Zealand white rabbits. The rabbits were then imaged with MR, contrast-unenhanced CT, and PF 4 days after infection. Histologically, periosteal elevation was present in 27 cases. Periosteal ossification was seen in 23 cases, and cellular reaction without ossification in 4 cases. Periosteal reaction was demonstrated by PF in 21 (78%) and by CT in 20 (74%) cases. Evidence of periostitis was seen by MR in all 27% (100%) cases. MR resulted in two false-positive diagnoses. Multiple concentric, alternating high and low signal arcs demonstrated by MR in 19 (70%) cases represented periosteal ossification surrounded by fibrous or granulation tissue. These findings demonstrate the ability of MR to detect periostitis despite the absence of periosteal ossification. MR was more sensitive than CT (P less than .05) or PF (P less than .05) in the detection of experimentally induced periostitis.

Acute Disease↗
PubMed1990

The frequency and diagnostic significance of periostitis in chondroblastoma.

A study was performed to determine the frequency of periosteal reaction associated with chondroblastoma, to investigate the underlying pathophysiology of the periosteal reaction, and to postulate the clinical importance of this radiographic observation. Two hundred fourteen histologically proved chondroblastomas were reviewed and observed for the presence or absence of periosteal reaction and for radiographic changes that might explain the cause of the periosteal reaction. A similar review was performed on 30 other epiphyseally centered lesions of various causes. A distinctive thick, solid periosteal reaction distal to the chondroblastoma was present in 47% of all chondroblastomas and 57% of chondroblastomas present in long bones (excluding the greater trochanter). No periosteal reaction was observed in any of the 30 epiphyseally centered lesions of other causes. When available for observation, plain films showed inflammatory changes in the joint surrounding the chondroblastoma, bone scintigraphy showed tracer uptake similar to that observed in inflammatory lesions and aggressive neoplasms, and MR images showed change in the marrow surrounding the chondroblastoma consistent with edema. This suggests an inflammatory reaction to the chondroblastoma, rather than mechanical stress across a weakened epiphysis, as the cause of the periostitis. We conclude that frequently the chondroblastoma produces a distinctive thick solid or layered periosteal response distant from the lesion along the diametaphyseal shaft. Observation of this unique periosteal response may help to distinguish chondroblastoma from other epiphyseally centered lesions.

Adolescent↗
PubMed1981

Prospective study of periostitis and finger clubbing in primary biliary cirrhosis and other forms of chronic liver disease.

The association of finger clubbing and periostitis has been reported in primary biliary cirrhosis and, more rarely, in other forms of chronic liver disease. The prevalence of periostitis and its relationship to finger clubbing is unknown. In this prospective study, we have determined the prevalence of periostitis and finger clubbing in 74 patients with primary biliary cirrhosis and 54 with other forms of chronic liver disease. Clubbing was present in 24% of patients with primary biliary cirrhosis, 29% with HBsAg negative chronic active hepatitis, and 23% in the group of miscellaneous liver diseases. Symmetrical periostitis affecting the tibiae and fibulae occurred in 35% of patients with primary biliary cirrhosis, 29% with chronic, active hepatitis and 40% of patients in the miscellaneous group. The distal radii and ulnae were affected in only eight patients (6%). In primary biliary cirrhosis, the presence of finger clubbing was strongly associated with periostitis (P less than 0.01), but this association was uncommon in other forms of chronic liver disease. In all forms of chronic liver disease periostitis commonly occurs in the absence of finger clubbing. Marked tenderness over the distal leg bones is a reliable sign of underlying periostitis, but this sign is present in only a third of affected patients. This study indicates that periostitis affecting the lower leg bones is common in patients with chronic liver disease, and its presence should be sought whether or not the patient has finger clubbing.

Adult↗
PubMed1983

Transverse periosteal sectioning and femur growth in the rat.

Circumferential cuts through the periosteal covering of long bones have been demonstrated to transiently increase epiphyseal growth. This effect appears to be independent of vascular changes accompanying surgery and has been hypothesized to relate to releasing tension in the periosteal envelope. This study was designed to address problems of previous investigations by controlling for the effects of the surgical procedure and by using regression analyses to analyze intra- and interanimal variations in the length and proportionality of the femur in experimental, sham, and control Sprague-Dawley male rat littermates. Experimental animals received circumferential periosteal sectioning of the right femur and no operation to the left limb. A sham operation without periosteal sectioning was performed on the right femur in the sham group. Right to left differences were analyzed using two multiple regression models; one involved three absolute length measurements as the dependent variables, while the other used the three ratios of these length measurements as the dependent variables. The ratio measures were utilized to reflect changes in bone proportionality. Circumferential periosteal section was followed by an alteration in the shape of rat femurs at 2 weeks postsurgery with a slight retardation of the length dimension from medial epicondyle to head of the femur and an overgrowth of the length dimension from the lateral epicondyle to the greater trochanter. The sham procedure produced a proportional decrease in all length measurements. The experimental procedure was also associated with surface bone apposition at the site of section. At 3 weeks postsurgery, normalization of bony contours between sham, experimental, and control groups had occurred; however, there were still some statistically significant decreases of length dimensions in the sham and experimental groups. In the experimental group the length measurement involving the weight-bearing head of the femur remained reduced at 3 weeks postsurgery. It is hypothesized that the functional demands of the long bone play an important role in the effect of periosteal regulation on growth. In situations where a normal tensive force is exerted on the bone, the periosteal envelope will act to restrain epiphyseal growth. When the bone is under a normal compressive force the release of periosteal tension is not a quantitatively significant stimulus to epiphyseal growth and the effects of surgical intervention and muscle trauma will play a more important role in the growth response of the epiphyses.

Animals↗
PubMed1991

Culture-expanded human periosteal-derived cells exhibit osteochondral potential in vivo.

Periosteal cells were enzymatically liberated from human rib periostea obtained from autopsies of 37 donors with an age distribution ranging from 25 weeks of gestation to 88 years old. These cells were introduced into cell culture and subcultured when they reached confluence. After subculture, the adherent periosteal-derived cells showed a nondescript, fibroblast-like morphology in cell culture. The cells from various passages of each donor were tested for in vivo osteochondrogenic potential with three different assay methods in athymic mice: (a) inoculation assay--the cells were directly inoculated into a subcutaneous site, (b) porous ceramics assay--the cells were combined with porous calcium phosphate ceramics, and this composite graft was implanted into a subcutaneous site, and (c) diffusion chamber assay--the cells were loaded into diffusion chambers and cultured in the peritoneal cavity. Frozen-preserved and recultured periosteal-derived cells were also assayed in the same way. In cases of donors younger than 19 years old, cultured, periosteal-derived cells from up to several passages consistently formed bone and/or cartilage in each of the three assays. Frozen-preserved and recultured cells from these donors also formed bone and/or cartilage after introduction into the three in vivo assays. In cases of donors older than 22 years of age, cultured, periosteal-derived cells formed neither bone nor cartilage in vivo. Cultured muscle fibroblasts from some of the same donors did not form bone or cartilage when assayed in vivo under identical conditions. These results suggest that periosteal cells with osteochondrogenic potentials can be liberated from the periosteum of a rib of human donors up to a certain age. Importantly, this potential is retained after enzymatic liberation, cell culture, subculturing, and freeze preservation. The present results suggest that culture-expanded human periosteal-derived cells from young donors may be useful in the repair of skeletal defects to foster cell-mediated regeneration of skeletal tissues, and that this methodology can be used to elucidate cellular, molecular, and genetic disorders in various metabolic bone diseases and skeletal dysplasias.

Adult↗
PubMed1985

Studies on the osteogenic potential of vascularized periosteum: behavior of periosteal flaps transferred onto soft tissues.

We investigated the basic properties of vascularized periosteal autografts. A pleuro-periosteal flap based on the intercostal vessels was developed in a canine model. Fourteen animals had vascularized periosteal flaps rotated onto the soft tissues of the chest wall. These animals were killed at intervals of 7 to 90 days and the flaps were studied by tetracycline labeling and light microscopy. Four other animals had similar flaps transplanted onto the soft tissues of the neck by microvascular techniques. All harvested flaps showed periosteal bone production, leading to the following observations: Osteogenesis begins as early as 7 days after grafting; the rate and extent of periosteal osteogenesis is proportional to the vascular supply; bone formation starts in small foci of active osteoblasts that grow and become confluent; and intimate bony periosteal contact is not necessary for periosteal osteogenesis to take place, but it appears to influence the rate and amount of bone formation.

Animals↗
PubMed1978

Osteogenic capacity of periosteal grafts. A qualitative and quantitative study of membranous and tubular bone periosteum in young rabbits.

A standardized model, permitting only periosteal bone formation, has been applied for qualitative and quantitative studies on the osteogeneses from periosteal grafts. The periosteum from the tibia was grafted to the skull and vice versa. The investigation also included the study of periosteal bone formation combined with other osteogenic factors. A total of 78 operations were performed on the tibias and skulls of 43 growing rabbits. For qualitative studies ordinary histological methods were used. Tibial periosteal grafts to skull defects started bone formation already after 2 weeks and, via a very small amount of woven bone, compact bone and bone marrow was formed after 8-10 weeks. Combined epidural and subperiosteal bone formation gave a calvarial bone. Skull periosteal grafts to tibial defects started bone formation somewhat later, but, after more woven bone as an intermediate stage, the defect had healed with thick compact bone and bone marrow after about the same period. For quantitative studies the newly formed periosteal bone was removed, dry-weighted and ashed. The ashes were dissolved in HCl for spectrophotometric determination of total Ca content, which was used as a quantitative measure of bone amount. Tibial periosteum grafted to a calvarial defect halved its bone forming capacity but compared to the in situ skull periosteal potential, the capacity was tripled. This meant that the defect was completely healed. Calvarial periosteum was much less potent than was the tibial periosteum, when both were grafted to skull defects. However, when transplanted to a long bone defect the former increased its bone forming capacity 5 times compared to its original one as an in situ flap. Environmental functional demands seem to influence the type of bone formation and the final structure of the new bone. On the other hand, there are differences between long and membranous bone periosteum regarding the amount of bone formed.

Animals↗