Related Experiment Video

Updated: Jun 19, 2026

Assessment of the Efficacy of An Osteopathic Treatment in Infants with Biomechanical Impairments to Suckling
07:11

Assessment of the Efficacy of An Osteopathic Treatment in Infants with Biomechanical Impairments to Suckling

Published on: February 5, 2019

Physiological periostitis in a 2.5-month-old baby

Oya Haicioğlu1, Sezin Aşik-Akman, Işin Yaprak

  • 1Department of Pediatrics, The Ministry of Health Tepecik Training and Research Hospital, Izmir, Turkey.

The Turkish Journal of Pediatrics
|October 13, 2009
PubMed

Insights

Physiological periostitis is a common X-ray finding in infants aged 1-6 months, often mistaken for abuse. This condition, characterized by bone reactions, requires careful consideration to avoid misdiagnosis in infants.

Area of Science:

  • Pediatric Radiology
  • Neonatal Imaging
  • Skeletal Dysplasias

Background:

  • Periosteal reactions in infants have diverse causes.
  • Physiological periostitis is a recognized radiographic finding in infants aged 1-6 months.
  • This finding can be misdiagnosed as non-accidental trauma or pathological conditions.

Observation:

  • A 2.5-month-old infant presented with fever and arm swelling post-vaccination.
  • Radiographs revealed bilateral periosteal reactions in the humeri, radii, tibiae, and femora.
  • Initial differential diagnoses included child abuse and congenital syphilis.

Findings:

  • Normal physical examination and serological-biochemical data were noted.
  • The clinical presentation and imaging findings led to a diagnosis of physiological periostitis.
  • This highlights the importance of considering benign causes of periosteal reactions.

Implications:

  • Physiological periostitis should be included in the differential diagnosis for infants presenting with periosteal reactions.
  • Accurate diagnosis prevents unnecessary investigations and potential misinterpretations, such as child abuse.
  • Radiologists and clinicians should be aware of this benign entity in infant skeletal imaging.

Related Concept Videos

Development of the Oral Microbiota01:28

Development of the Oral Microbiota

The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
Development of Immunocompetence01:22

Development of Immunocompetence

The initiation of cell-mediated immunity can be observed as early as the third month of fetal growth, with active antibody-mediated immunity following approximately one month later.
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
Bone Formation by Intramembranous Ossification01:29

Bone Formation by Intramembranous Ossification

Intramembranous ossification is one of the two processes involved in the development of bones within an embryo. The flat bones of the face, most of the cranial bones, and the clavicles are formed via this process. During intramembranous ossification, the bones develop directly from sheets of undifferentiated mesenchymal connective tissue.
The process begins when mesenchymal cells in the embryonic skeleton gather together and differentiate into osteogenic cells, which then develop into...
Bone Disorders01:29

Bone Disorders

Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Tonsillitis II: Management01:26

Tonsillitis II: Management

This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.