Inflammatory process in the periosteum of the lower leg (periostitis) may begin to develop due to injury or regular heavy load on the lower limbs. The first signs of pathology are tissue swelling and severe pain. You should not get rid of only the symptoms, because the development of inflammation will continue. It is necessary to initially determine the type of disease and start treatment as soon as possible.
Inflammation in the periosteum of the lower leg can be acute or chronic. If you look at the problem from an anatomical point of view, then the periosteum is connected directly to the bone. In this regard, the inflammation that develops in the tissues can easily go to the bone. If you do not start treatment on time, then not only the outer layers of the bone, but also the deeper ones will be affected. According to ICD-10, the periostitis code is M90.1.
Causes of the inflammatory process
Shin periostitis is very often diagnosed inthose people who are professionally involved in athletics or martial arts. In this case, the following reasons will influence the development of the pathology:
- running in terrain where there are many steep grades and very sharp climbs;
- training too much;
- there was a violation of the integrity of the tendons or bones of the lower leg, there were severe bruises of the lower leg;
- inflammation is allergic or rheumatic;
- due to constant contact with chemicals, there has been a significant accumulation of toxins (this could also happen as a result of some other diseases).
In medical practice, there are very often cases when pathology occurs due to a weak muscular apparatus. Also, periostitis of the lower leg can develop as a complication of tuberculosis.
Types of pathology and its clinical picture
Not always the inflammatory process in the periosteum of the lower leg will proceed in the same way. In each individual case, there may be a different course. In this regard, experts distinguish several main types of periostitis (ICD-10 code - M90.1).
Simple type
Occurs as a result of bruising, myositis or fracture. Puffiness appears in the region of the periosteum of the lower leg, in the soft tissues of the joint or near the bones of the ankle. There are mild aching pains. Discomfort occurs due to overcrowding of tissues with blood and pressure on the affected area. The chronic form of simple periostitis occursonly in isolated cases.
Inflammatory process of fibrous type
The disease begins to develop due to too long squeezing of the connective tissue. In most cases, it occurs against the background of pathologies such as arthritis, trophic ulcers. Fibrous inflammation of the periosteum of the leg develops very slowly, then gradually develops into a chronic form. If you press on the lower leg, then there will be no pain. Visually marked compaction and hyperemia of the skin. Treatment should begin with the elimination of the underlying disease.
Albuminous type
In the presence of this type of periostitis, exudate begins to accumulate in the connective tissue. A bone-like sac is almost always formed. It occurs most often as a result of trauma to the osseous apparatus of the lower leg. Pathology can proceed in a subacute or chronic form.
The main signs of albuminous periostitis include:
- pain in the lower leg when pressing on the affected area;
- at the initial stage of the development of the disease, body temperature rises;
- mobility is limited several times;
- skin hyperemia appears;
- in the first stage, swelling and a noticeable induration appear.
If you detect albuminous periostitis at an early stage of development, then you can only get by with suction of the exudate. If the disease is started, then the only treatment option is surgery.
Purulent type
This form of pathology develops as a result ofre-infection of the periosteum after the bone apparatus was injured. Another reason may be the appearance of a purulent process in the tissues that are nearby. These can be diseases such as phlegmon, osteomyelitis, abscess.
Inflammation of the periosteum of the shin of a purulent type always has an acute onset. Initially, exudate begins to accumulate in the tissues, which quickly turns into pus. The body temperature begins to rise rapidly, there is a severe headache, chills, body aches. The affected area swells, but pain does not appear when pressed.
If such a diagnosis was made as purulent periostitis of the lower leg, then there may be two options for the development of the pathology:
- A purulent sac breaks through, and its contents pour out inside, which leads to the development of an inflammatory process in the soft tissues.
- Content comes out and breaks the skin.
Purulent form of periostitis of the lower leg is considered the most severe and dangerous. As a complication, necrosis or even bone decay and oncology may appear.
Ossifying type
This form of the disease occurs most often and involves the development of inflammation in the connective tissue of the lower leg due to irritation of the periosteal tissue. The inflammatory process can be:
- primary type;
- secondary type, which develops due to the presence of a chronic form of osteomyelitis, rickets, arthritis (tuberculosis, malignant bone formation or syphilis acts as a provoking fact).
Features of the ossifying type are the appearance of osteophytes, as well as bone-like swelling.
Diagnosis of disease
Almost all forms of periostitis do not have clearly defined symptoms, so it will not work to make a correct diagnosis based on external examination alone. To determine the provoking factors, palpation and a thorough history taking will be required. Also used are diagnostic methods such as:
- radiography;
- laboratory type research.
Be sure to study the sample that contains the abscess.
Periostitis treatment
After the diagnosis is finally confirmed, the doctor will advise you to forget about training for a while and minimize the physical load on the ankle. At the same time, the complete absence of load will not have a positive effect on the condition of the affected area. Exercises for the treatment of the periosteum of the lower leg are selected solely taking into account the clinical picture of the disease. The patient should regularly perform special exercises that help to rehabilitate and strengthen the muscular apparatus, but do not overload it.
An interesting fact is that the pain in the lower leg can increase or disappear. But we must remember that the disappearance of pain is not a sign of recovery. Even if the periosteum of the lower leg does not hurt, it is necessary to follow the recommendations of a specialist, otherwise the inflammation can very quickly become chronic. Therefore, it is very important to seek help in timehospital and follow the doctor's instructions.
Treatment of the initial stage of periostitis of the lower leg is carried out on an outpatient basis. But if complications begin to appear, then urgent hospitalization of the patient is a prerequisite. In some cases, it is even impossible to do without surgical intervention. Regardless of the present stage and form of the disease, the patient must take prescribed medications. They will help eliminate the inflammatory process and neutralize the allergic reaction. Also, the doctor without fail prescribes a course of taking vitamin complexes and calcium directly.
If the periosteum of the lower leg hurts when walking, physiotherapy is often prescribed, which shows good results. Massage, dry heat, or paraffin therapy may also be prescribed.
Therapy with folk remedies
Folk remedies for the treatment of periostitis can be used both independently and together with the traditional method of therapy.
Many medicinal plants have anti-inflammatory effect. They also reduce swelling, redness, and relieve pain. If you take decoctions or tinctures of special herbs, then the bone structures begin to recover several times faster.
For the treatment of periostitis, a plant such as common comfrey is very often used. It contains a huge amount of useful components that help cure pathology and prevent the development of other diseases of the joints andbones.
In order to treat the inflammatory process in the periosteum, you need to prepare a special ointment. For her use 100 grams of butter and comfrey root. The butter must be melted in a water bath and then add the powdered comfrey root to it. The mixture is thoroughly mixed and continues to heat up. After that, you need to give half an hour to the resulting product so that it cools down and infuses. Healing ointment lubricates the affected area. You can store the medicine in the refrigerator.
The non-acute form of periostitis of the shin is perfectly treated with the Adam's root (it also has the name tamus ordinary). To prepare the tincture, take 200 grams of root and pour half a liter of vodka. The remedy is infused for five days in a dark, cool place. Then the finished tincture can be rubbed into the affected area. Then wrap it with a woolen cloth.
If the disease occurs in an acute form, then the affected area should never be warmed up. This can lead to the development of complications and the spread of the inflammatory process to neighboring he althy tissues.
Possible Complications
If you go to the doctor too late or choose the wrong treatment, this can cause many serious complications. May appear:
- abscess;
- phlegmon;
- osteomyelitis;
- sepsis.
To avoid the occurrence of various complications, you must strictly follow all the recommendations of the attending physician. If there is an injury to the leg, thenthe problem should be treated immediately. Also, patients with this disease should not wear high-heeled shoes. It is better to choose models that have a comfortable orthopedic sole, insole.
If you start treating the disease on time, then getting rid of the problem will be quite simple. You should not delay visiting a specialist if you notice discomfort in the lower leg area or swelling and pain. Otherwise, the pathology can become chronic and cause complications.
