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Case Report
Congenital bilateral periostitis: Differential diagnosis and a case report
1 Pediatrician, Department of Pediatrics, Limassol General Hospital, Cyprus
2 Medical Student, University of Cyprus, Cyprus
3 Paediatric Orthopaedic Surgeon, Department of Orthopaedic Surgery, Nicosia General Hospital, Cyprus
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Egor Kostin
Nicosia General Hospital, 215, Paleos Dromos Lefkosia-Lemessos str., 2029 Strovolos, Nicosia,
Cyprus
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Article ID: 100030Z14AE2024
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Elia A, Kostin E, Charalambous E, Orfanos I. Congenital bilateral periostitis: Differential diagnosis and a case report. J Case Rep Images Orthop Rheum 2024;7(2):1–4.ABSTRACT
Introduction: Periostitis, characterized by radiological findings of periosteal new bone formation, can result from various factors including trauma, drugs, infection, and tumors. Among infants up to six months of age, common causes of periostitis include physiologic periostitis of the newborn, Caffey disease, periostitis related to prostaglandin use, and congenital syphilis. The differential diagnosis of bilateral symmetrical periostitis in newborns and infants within this age range is important as it contributes to the possibility for early treatment.
Case Report: A 3-month-old girl, born at 38 weeks by natural birth and with unremarkable prenatal history, presented with multiple episodes of vomiting, loss of appetite, fever, saddle nose, prominent forehead, maculopapular rash with vesicles in both palms, and a palpable liver. Her weight was below the 3rd percentile on growth charts. The infant’s syphilis serum screening test was reactive, leading to further testing. Treatment with crystalline penicillin G was administered, and diagnostic investigations revealed symmetrical periostitis affecting the diaphysis of bilateral femorae and tibiae.
Conclusion: This case report highlights the importance of considering congenital syphilis in the differential diagnosis of bilateral symmetrical periostitis in newborns and infants up to six months of age. Early diagnosis and appropriate treatment are crucial. This case report adds to the orthopedic literature by presenting a unique case of congenital syphilis-associated periostitis, emphasizing the significance of considering this etiology in similar clinical scenarios. Increasing awareness of such cases can lead to prompt diagnosis and intervention, ultimately contributing to better clinical outcomes in affected infants.
Keywords: Bilateral periostitis, Caffey disease, Congenital syphilis, Differential diagnosis
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Acknowledgments
Special thanks to the guardian of the patient for the cooperation during the therapy.
Author ContributionsAnna Elia - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Egor Kostin - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Elena Charalambous - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Ioannis Orfanos - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Anna Elia et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
