Florid reactive periostitis of the metacarpal and phalanx: 2 case reports

Area of Science:

• Orthopedic Surgery
• Radiology
• Pathology

Background:

• Florid reactive periostitis is a rare benign fibro-osseous lesion.
• It typically presents as a soft tissue proliferation of fibrous connective tissue and mature bone.
• This condition commonly affects the finger but rarely the metacarpal bone.

Observation:

• The lesion can mimic malignant and infectious disorders, potentially leading to incorrect treatment.
• Standard radiography often reveals an ossified mass on the hand bones without cortical disruption.
• This report details two cases: one with an unossified mass and bone marrow edema in the metacarpal, and another with cortical destruction in the phalanx.

Findings:

• Computed tomography (CT) and magnetic resonance imaging (MRI) provide detailed insights into the lesion's characteristics.
• Imaging findings in these cases included unossified components and adjacent bone marrow edema.
• Cortical destruction was observed in one case, highlighting the varied presentations.

Implications:

• Accurate diagnosis is crucial to avoid unnecessary or incorrect treatments for this benign condition.
• CT and MRI offer superior diagnostic value compared to routine radiography for florid reactive periostitis.
• Understanding the diverse imaging manifestations is key for effective clinical management.