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Tibial Periosteal Reaction
Sunil Taneja, Rakhi Jain, Gulnaz Nadri, Shailendra Singh.
Madhuraj Hospital, Kanpur, India.
ADDRESS FOR CORRESPONDENCE
Dr. Rakhi Jain, 98,Y1,Kidwai Nagar, Kanpur, India.
Email: drrakhi09@gmail.com
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What is the diagnosis?
Caffey’s disease or Infantile Cortical Hyperostosis {ICH}. It is a rare disorder of unknown etiology. Among the proposed causes are, infections, immunological defects and genetic abnormalities. {1} It is characterized by cortical hyperostosis along with inflammation of the adjacent muscle and fascia. Usually sporadic in nature but may be autosomal dominant or autosomal recessive. {2} Mutations of the COL1A1gene {codes for the a1chain of type I collagen} has been reported. {3,4} It usually presents in infancy with sudden irritability, soft tissue swelling over the involved bones having a woody induration without suppuration, fever and anorexia. Mandible is the most commonly involved site followed by scapula, clavicle, ribs and long bones. There are usually no other signs and symptoms. {1}The disease may be self-limiting but is also known to have an unpredictable course with remissions and relapses. A high index of suspicion with a good radiology and laboratory backup is thus necessary to make a diagnosis and plan treatment. Differential diagnosis includes osteomyelitis, hypervitaminosis A, syphilis, scurvy, hyperphosphatemia, bone tumors and child abuse. Radiography is the most valuable diagnostic study in ICH showing cortical new bone formation {cortical hyperostosis} beneath the regions of soft tissue swelling, which is the characteristic feature. While no laboratory tests are specific for diagnosis of ICH, the present case had the typical radiological features while normal laboratory parameters helped rule out other differential diagnosis. Caffey’s disease is mostly self-limiting and resolves within six months to one year and may not need any treatment. However, indomethacin or naproxen could be used in really symptomatic cases. {5} This case highlights the involvement of long bones in Caffey’s Disease. |
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| Compliance with ethical standards |
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Funding: None
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Conflict of Interest: None
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DOI: https://doi.org/10.7199/ped.oncall.2014.41 |
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Cite this article as:
Taneja S, Jain R, Nadri G, Singh S. Tibial Periosteal Reaction. Pediatr Oncall J. 2014;11: 92. doi: 10.7199/ped.oncall.2014.41
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