Florid Reactive Periostitis of the Metacarpal and Phalanx: 2 Case Reports

• Published in: The Journal of hand surgery (American ed.) Vol. 38; no. 11; pp. 2134 - 2137
• Main Authors: Gao, Zhenhua, MD, Wang, Jifei, MMed, Wang, Zhuo, MD, Meng, Quanfei, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2013
• Subjects: Adolescent; Bone Neoplasms - diagnosis; Diagnosis, Differential; Female; Finger Phalanges; Fingers; florid reactive periostitis; Humans; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; metacarpal; Metacarpus; MRI; Orthopedics; Osteomyelitis - diagnostic imaging; Osteosarcoma - diagnosis; Periostitis - diagnosis; Periostitis - diagnostic imaging; Periostitis - pathology; radiographs; Tomography, X-Ray Computed; Young Adult; CT; metacarpal; florid reactive periostitis; MRI; radiographs
• ISSN: 0363-5023; 1531-6564
• DOI: 10.1016/j.jhsa.2013.08.115

Florid reactive periostitis is a rare benign fibro-osseous proliferative lesion of soft tissue and is mainly composed of fibrous connective tissue and mature bone. The lesion usually occurs in the finger and seldom in the metacarpal. The lesion mimics malignant and infectious disorders, thus often leading to inappropriate treatment. Radiography usually shows an ossified mass attached to the underlying hand bones without interruption of the cortex. We report 1 case of florid reactive periostitis with unossified mass and underlying bone marrow edema in the metacarpal of hand and 1 case with adjacent cortical destruction in the phalanx. In addition, we describe the imaging findings of computed tomography CT and magnetic resonance imaging MRI and discuss their diagnostic values compared with routine radiographic examination.