Proliferatif periostitis (Garre osteomiyeliti): Literatür derlemesi ve olgu bildirimi

Proliferative periostitis (Garre's osteomyelitis): Review of the literature and a case report

Özet

Garre osteomiyeliti olarak da bilinen Proliferatif peri¬ostitis, periosteumun düşük dereceli enfeksiyonlara karşı gösterdiği, tabakalar halinde yeni kemik oluşu¬muyla karakterize nadir görülen bjr hastalıktır. Bu ça¬lışmada, sekiz yaşındaki bir erkek hastada alt süt II. molar diş periapikal enfeksiyonuna bağlı gelişen proli¬feratif periostitis olgusu sunulmuştur. Proliferatif pe-riostitisin tüm klasik bulgularına ilaveten son derece nadir izlenilen kutanöz Fıstül gelişimi ve pü drenajı gö¬rülmüştür. Lezyon, antibiyotik tedavisini takiben spontan remisyonla iyileşmiş ve belirgin fasiyal asimet¬ri oluşturan kemikte rezorpsiyon izlenmiştir. Teşhis amacıyla yararlanılan periapikal, okluzal, panoramik ve bilgisayarlı tomografik radyografi ve 99m Tc-MDP sintigrafik tetkik bulguları irdelenerek, geniş bir litera¬tür derlemesi eşliğinde tartışılmıştır.

Abstract

Proliferative periostitis, commonly known as Garre's oste¬omyelitis, is an uncommon reaction of periosteum to low-grade infection and is characterized by new bone formation in the periosteum with radiographic onion-skin appearan¬ce. In this study a case of proliferative periostitis of mandible due to periapical infection originating from the lower deci¬duous second molar tooth in a eight-year old child is repor¬ted. All of the classical features of proliferative periostitis were seen except for the cutaneous fistulas with pus draina¬ge which has been reported only in one instance. Cutaneous fistulas were completely healed after antibiotic therapy for 13 days. Expansile bony lesion of the mandible was resor-bed gradually and asymmetrical apperance of the face was returned to normal. Special emphasis was given to the diag¬nostic imaging including periapical, occlusal, panoramic, computed tomographic, and 99m Tc-MDP scintigraphic fe¬atures of the lesion. Differential diagnosis of mandibular thickening due to periosteal proliferation is also discussed with a review of the literature