Periosteal reaction in systemic lupus erythematosus

doi:10.1016/j.jbspin.2007.01.035

Joint Bone Spine

Volume 74, Issue 6, December 2007, Pages 650-652

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Abstract

Musculoskeletal complaints are the most common presenting symptoms in most of the patients with systemic lupus erythematosus (SLE). However, periosteal new bone formation is an extraordinarily rare condition in SLE. We report a case of periosteal reaction in SLE. A 31-year-old woman with SLE presented with both knee pain. Radiographs revealed periosteal reactions in both femur and tibia and around the metaphysis of the right distal tibia. Periosteal reaction can be caused by benign or malignant lesions and infection. We cannot find any other cause of periosteal reaction in our case after thorough evaluations. Periosteal reaction in SLE might be associated with inflammatory vascular changes. This is the first report of periosteal reaction in SLE after the 1990s description and the first report in Korea.

Introduction

Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease with a variety of clinical manifestations, which is characterized by a persistent nonspecific polyclonal B-cell activation that results in widespread tissue deposition of immune complexes and multiorgan involvement.

Periosteal new bone formation (periosteal reaction) can result from a variety of causes. Periosteal reaction has been reported in association with polyarteritis nodosa [1], [2], [3], giant cell arteritis [4], Takayasu's arteritis [5] and SLE [6], [7], respectively. There are no case reports of periosteal reaction in SLE after the 1990s description of periostitis in association with SLE. Thus, we report such a case.

Section snippets

Case report

A 31-year-old woman was diagnosed as having systemic lupus erythematosus in 1993 by fever, malar rash, polyarthritis, positive antinuclear antibody and elevated anti-dsDNA titer. Her symptoms, signs and laboratory results met the ARA criteria. In May 1998, she was referred to our hospital because of mesenteric vasculitis with symptoms of diarrhea, abdominal pain and fever. She also complained pain and swelling of both knee joints and right ankle pain. Concomitantly, her history was marked by

Discussion

Periosteal new bone formation (periosteal reaction) can be seen as one or more thin lines that closely parallel to the cortex of the bone. Radionuclide bone scan in periosteal reaction often demonstrates a pericortical linear concentration of nuclide along the involved bone shafts. There could be many causes which induce periosteal bone formation.

Periosteal reaction in association with polyarteritis nodosa was described in about 20 reported cases [1], [2], [3]. It is not a common feature of

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There are more references available in the full text version of this article.

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Case reportPeriosteal reaction in systemic lupus erythematosus

Abstract

Introduction

Section snippets

Case report

Discussion

Clin Radiol

Int J Cardiol

Periosteal new bone formation in polyarteritis nodosa: a syndrome involving the lower extremities

Arthritis Rheum

Periarteritis nodosa and subperiosteal new bone formation

J Bone Joint Surg Br

Periosteal new bone formation complicating juvenile polyarteritis nodosa

J R Soc Med

Case report
Periosteal reaction in systemic lupus erythematosus