In the mandible the sequestrum becomes surrounded by a sheath of new periosteal bone, so that, even if the greater part of the jaw undergoes necrosis, the arch is reproduced, and after removal of the sequestrum little or no deformity results.
The periosteal sarcoma is the most malignant form.
The degree of deformity is often slight, because the transverse direction of the lesion, the breadth of the separated surfaces, and the firmness of the periosteal attachment along the epiphysial line often prevent displacement.
The periosteal form of vertebral tuberculosis is that most frequently met with in adults.
Osseous union is the exception in intra-capsular fracture, especially when the periosteum and the retinacular ligaments have been completely torn, but in sub-periosteal and in impacted fractures it sometimes occurs.
As mastoid complications may be mentioned: suppurative mastoiditis, leading to destruction of the bone, mastoid fistula, and sub-periosteal mastoid abscess.
While the occurrence of purely periosteal suppuration is regarded as possible, we are of opinion that the embolic form of staphylococcal osteomyelitis always originates in the marrow.
Localised tenderness is elicited on pressure, and there is slight swelling, which, however, rarely amounts to what may be described as a periosteal node.
A central gumma in a long bone may not reveal its presence until it erupts through the shell and reaches the periosteal surface or invades an adjacent joint.
When it affects the lower jaw, in its early stages, actinomycosis may closely simulate a periosteal sarcoma.
Periosteal tumours are at first situated on one side of the bone, but as they grow they tend to surround it completely.
Periosteal tuberculosis# is met with in the ribs, sternum, vertebral column, skull, and less frequently in the long bones of the limbs.
In the case of a metacarpal or metatarsal bone, sub-periosteal resection is the procedure of choice, saving the articular ends if possible.
Most difficulty is met with in relation to periosteal sarcoma, which must be differentiated either by the X-ray appearances or by an exploratory incision.
The first change is due to the deposit of new bone on the periosteal surface; later, there is the shadow of the sequestrum.
The periosteal gumma appears as a smooth, circumscribed swelling which is soft and elastic in the centre and firm at the margins, and shades off into the surrounding bone.
In the latter case the fragments are held together by the periosteum when it is intact; in that case the fracture belongs to the intra-periosteal class.
In cases of periosteal thickening, the results vary with the time at which the treatment is begun.
The most common lesion is one which affects the periosteum and leads to the formation of periosteal bone.
In cases of combined endosteal and periosteal thickening, the pain usually disappears under anti-syphilitic treatment but the changes in the bone persist.
The presence of circumscribed periosteal thickening of bone in itself should always lead to the suspicion of the presence of syphilis.
In the chronic stage there is usually an old necrotic shaft perforated by sinuses, and often freely movable, inclosed by a shell of dense periosteal bone.
This periosteal formation may occur either in congenital or in acquired syphilis, and it may affect one or many bones.
In the periosteal sarcomata, a new formation of bone is common and the bone is frequently arranged in a radical way, giving a most remarkable picture on the X-ray plate.
In many cases the periosteum, as about any form of foreign body, then begins to proliferate and forms a shell of periosteal bone surrounding the tumor.
The cases in which there is both endosteal and periosteal thickening, occur chiefly in children and are of a congenital nature.
In many cases new growth of bony tissue is due to the new formation of periosteal bone, and is an expression of an attempt at repair of one or the other of the numerous destructive processes.
The periosteal thickening may occur at any time of life over any bone of the body.
In the early cases, a thorough anti-syphilitic treatment may lead, after a varying length of time, to complete disappearance of the newly formed periosteal bone.
On the other hand, if the periosteal process has lasted for a long time and the bone has become densely cortical, although anti-syphilitic treatment may lead to a diminution of the localized pain, the dense bone does not disappear.
They are not as frequent as might be expected, from the limits within which the dispersion of the fragments is restricted by their periosteal and other connections, and the yielding mobility, before mentioned, of the vessels themselves.
The bones are so fragile that great care {163} is needed sometimes not to fracture or to infract them and to avoid periosteal pain in lifting.
The second symptom is the thoracic groove, to which I shall allude later, and a gradual thickening of the costo-cartilaginous junctures, with or without periosteal pain on pressure.
Periosteal thickening is mainly noticed about the intermaxillary bone--sometimes to such an extent that above and behind it a considerable impression takes place.
The same process is in active operation in the deep periosteal layers, the material accumulating to such a degree as to add much to the thickness of the shaft.
For periosteal proliferation at that early period contracts the foramina carrying the blood-vessels, and, while interfering with the size of the bones, the foramen magnum also.
Besides, the periosteal proliferation around the alveoli is excessive, sometimes so much so as not only to crowd the teeth into irregular positions, but even to absorb and annihilate alveolar processes in the course of the morbid changes.
Periosteal nodes on one or many of the long bones; sudden, symmetrical, and complete deafness, without otorrhoea and unattended by pain or other subjective symptoms.
Still, it is possible that a moderate amount of periosteal and osteal hyperaemia and over-irritation matures the teeth abnormally.
If the relative percentage of lime were of any account in the etiology of rachitis, the periosteal and cartilaginous proliferations would find no explanation.
In fact, a sub-periosteal fracture may exist for several days or a week or more and then, with subsequent fracture of the periosteum, crepitation and abnormal mobility of the member are to be recognized.
In this case, without doubt, the subject originally suffered a sub-periosteal fracture of the bone and because the animal was a good self nurse, the brachial fascia supported the radius until the periosteum gave way and the leg dangled.
They are usually sub-periosteal and when the periosteum is left intact or nearly so, no crepitation is discernible.
On the other hand, resolution may occur during the stage of periosteal inflammation, or, an exostosis forms which causes no interference with function.
The fibrous portion of the external meatus is separated carefully from the posterior wall of the bony meatus by means of a periosteal elevator, and is pulled forward by a retractor.
In the case of diffuse inflammation, although relapses are uncommon, superficial necrosis of a portion of the bony meatus may afterwards occur as a result of involvement of its periosteal lining.
The fibrous portion of the canal is carefully separated from the bony portion with the periosteal elevator, the growth, if possible, being exposed without tearing through the thin layer of skin which covers it.
Except in very muscular subjects, in whom the muscle comes low down into the wound and has to be cut through, it is better to push the lower border of the muscle upwards by means of a periosteal elevator.
The fibrous portion is now pulled outwards by means of a retractor, and the thickened tissue, forming the stricture, is peeled off from the surrounding bony meatus with a small periosteal elevator and so removed.
After them, the periosteal growth of bone became, as it were, a part of the principles of surgery.
There was an anesthesia of the shoulder-joint region, and of the outer surface of the arm; a hypesthesia of the posterior surface of the forearm and dorsal surface of the hand and fingers; tendon and periosteal reflexes normal.
Marked dermatographia and mechanical excitability of the muscles: periosteal reflexes strongly developed; numerous pressure points in the head.
The periosteal reflexes were increased; the deep reflexes could not be properly examined.
No joint lesions or periostealthicknesses were found by X-ray.
The connection of these "streamers" with the periosteal layer is evident.
About this time (1881) Gee presented a brief but accurate account of five cases of scurvy which he termed "osteal or periosteal cachexia.
Its cells do not present an orderly arrangement, the proliferating columns having disappeared in the central convex portion, and being present to a varying extent near the periosteal borders.
Loose fragments, by which those freed from their periosteal connections are meant, need removal.
The absorption of endochondral and formation of periosteal bone goes on, till in time it comes about that the whole of the shaft, except its terminations, is of periosteal origin.
The perichondrium thus becomes the periosteum, and the bone produced by it, is periosteal or membrane bone.
The periostealaffection alone is a troublesome and serious complaint.
The morbid structure had not broken through its periosteal investment.
The second kind are those which occur in the tertiary stage, and are the immediate precursors of the formation of periosteal nodes.
The above list will hopefully give you a few useful examples demonstrating the appropriate usage of "periosteal" in a variety of sentences. We hope that you will now be able to make sentences using this word.
