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Periostitis ossificans (Garrè's osteomyelitis) radiographic study of two cases
S K Kannan1, G Sandhya, R Selvarani
1Department of Oral Medicine & Radiology, Meenakshi Ammal Dental College & Hospital, Alapakkam Main Road, Maduravoyal, Chennai-602102, Tamil Nadu State, India. drskkomdr@yahoo.co.in
International Journal of Paediatric Dentistry
|December 21, 2005
Summary
Periostitis Ossificans (PO) in children presents with varied radiographic findings beyond the typical "onion skin" appearance. These variations can indicate disease duration, progression, and healing, influenced by the radiographs used for evaluation.
Area of Science:
- Oral Medicine
- Pediatric Dentistry
- Radiology
Background:
- Periostitis Ossificans (PO) is a non-suppurative osteomyelitis variant affecting the mandible, common in pediatric patients.
- Periapical infection of the mandibular first molar is the primary etiology.
- Radiographic hallmark includes lamellae of new periosteal bone, creating an
- onion skin
- appearance.
Observation:
- Two 11-year-old males presented with painless, hard mandibular swellings.
- Both cases exhibited periapical infection of the mandibular first molar and buccal cortical expansion.
- Radiographic studies, including Orthopantomograph and occlusal views, revealed diverse appearances of periosteal bone formation.
Findings:
- Radiographs showed single or multiple radiopaque lamellae outside the mandibular cortex.
- Mandibular contour was preserved in some cases (Type I), while altered in others.
- Classification varied based on radiographic modality, with Orthopantomograph and occlusal views yielding different subclassifications (e.g., Type I-1, I-2).
Implications:
- Periostitis Ossificans exhibits diverse radiographic presentations beyond the classic "onion skin" pattern.
- Radiographic features correlate with disease duration, progression, and healing stages.
- Accurate radiographic classification of PO is dependent on the imaging techniques employed.
