orbital periostitis

Orbital periostitis is an inflammation of the periosteum, a layer of connective tissue that surrounds the bones in the orbit (the bony cavity that contains the eyeball). This condition can be caused by various factors such as bacterial infections like actinomycosis, tuberculosis, or syphilis, osteomyelitis, or tooth germ inflammations in infants.

The clinical symptoms of orbital periostitis are similar to those of orbital cellulitis but less severe. They include:

• Unilateral upper and/or lower eyelid swelling
• Erythema (redness)
• Ocular motility that is painful and restricted
• Exophthalmos (bulging of the eye)
• Significant chemosis (swelling of the conjunctiva)
• Pupillary reaction and visual acuity still preserved

Orbital periostitis can occur at any age, but it is more common in children. In fact, studies have shown that 11% of cases occurred in the first decade of life, and it was twice as frequent in the second and third decades.

It's worth noting that orbital periostitis is not a disease itself, but rather a condition caused by inflammation of the periosteum due to trauma or infection.

Orbital periostitis, also known as periostitis of the orbit, is a condition characterized by inflammation of the periosteum surrounding the bones in the orbit. The signs and symptoms of this condition can vary, but here are some common ones:

• Swelling: Swelling of the eyelids, face, or orbit is a common symptom of orbital periostitis.
• Pain: Pain or tenderness to palpation over the affected area is often reported by patients with this condition.
• Proptosis: Proptosis, or bulging of the eye, can occur due to inflammation and swelling of the tissues surrounding the eye.
• Diplopia: Double vision or diplopia can be a symptom of orbital periostitis, especially if the inflammation affects the extraocular muscles.
• Vision loss: In severe cases, vision loss can occur due to compression of the optic nerve or other structures within the orbit.

According to [10], symptoms and signs of inflammatory orbital pseudotumor typically include a sudden onset of pain along with swelling and erythema of the eyelids. Proptosis, diplopia, and vision loss are also possible. In cases of reactive lymphoid hyperplasia or IgG4-related disease, there are typically few symptoms other than proptosis or swelling.

Additionally, [12] states that the cardinal signs and symptoms of orbital inflammation include swelling, erythema, pain, and possibly loss of function. The tempo of the disease is typically acute, often having onset over just a few days.

Orbital periostitis, also known as orbital inflammation, can be diagnosed through various diagnostic tests.

Imaging Studies

• Computed Tomography (CT) scans or Magnetic Resonance Imaging (MRI) with intravenous contrast are commonly used to evaluate the orbit and surrounding tissues. These imaging studies can help identify any abnormalities in the periosteum, bone, or soft tissues of the orbit [3].
• CT scans are particularly useful for detecting calcifications, fractures, or other bony abnormalities that may be associated with orbital periostitis [5].

Blood Tests

• A complete blood count (CBC) with differential can help identify any underlying infections or inflammatory conditions that may be contributing to the orbital inflammation.
• Blood tests such as erythrocyte sedimentation rate (ESR), C-reactive protein level, and titers of specific antibodies can also provide valuable information about the presence and severity of inflammation [8].

Other Diagnostic Tests

• Echographic diagnosis is sometimes used in cases where other imaging modalities are not feasible or have provided inconclusive results [2].
• Biopsy may be necessary in some cases to confirm the diagnosis, especially if there is suspicion of a specific underlying condition such as an infection or tumor.

It's worth noting that the choice of diagnostic test will depend on the individual patient's presentation and clinical history. A combination of imaging studies, blood tests, and other diagnostic tests may be used to arrive at a definitive diagnosis.

References:

[2] Echographic diagnosis in orbital complications of inflammatory diseases of he paranasal sinuses].62: Rochels R: 3320643

[3] by VBL Choi · 2011 · Cited by 26 — Radiologic orbital evaluation commonly involves computerized tomography scan (CT) or magnetic resonance imaging (MRI) with intravenous contrast and is very ...

[5] Jul 1, 2009 — A complete blood count with differential and cultures is helpful for identifying the infectious nature of the condition. CT scan of the orbits ...

[8] by VBL Choi · 2011 · Cited by 26 — Blood tests should be guided by clinical suspicions, as well as: complete blood count, erythrocyte sedimentation rate (ESR), C-reactive protein level, titres of ...

Orbital periostitis, also known as periostitis or orbital inflammation, can be treated with various medications to manage symptoms and prevent complications.

Medications used in the treatment of orbital periostitis:

• Corticosteroids: These are often the first line of treatment for orbital periostitis. Corticosteroids such as prednisone or methylprednisolone can help reduce inflammation and swelling in the orbit [3].
• Antibiotics: If the orbital periostitis is caused by a bacterial infection, antibiotics may be prescribed to treat the underlying infection [4].
• Disease-modifying antirheumatic drugs (DMARDS): In some cases, DMARDS such as methotrexate or sulfasalazine may be used to treat orbital periostitis, especially if it is associated with an autoimmune disorder [14].

Other treatment options:

• Surgery: In severe cases of orbital periostitis, surgery may be necessary to drain abscesses or remove infected tissue.
• Radiation therapy: This may be used in some cases to reduce inflammation and prevent further complications.

It's essential to note that the specific treatment plan for orbital periostitis will depend on the underlying cause, severity, and individual patient factors. A healthcare professional should be consulted for proper diagnosis and treatment.

References:

[3] MT Yen (2005) - The use of intravenous

Orbital periostitis, also known as periosteal cellulitis, is an inflammation of the periosteum, a layer of tissue that surrounds bones. When diagnosing orbital periostitis, it's essential to consider various differential diagnoses to rule out other conditions that may present similarly.

Here are some possible differential diagnoses for orbital periostitis:

• Orbital cellulitis: This is a more severe infection that affects the orbit and can be caused by bacteria or fungi. It often presents with symptoms such as eye pain, swelling, and redness.
• Periorbital cellulitis: This is an infection of the skin and soft tissues around the eye, which can also cause swelling, redness, and pain.
• Sinusitis: Inflammation of the sinuses can lead to orbital periostitis if the infection spreads to the orbit.
• Trauma: Physical trauma to the eye or surrounding area can cause inflammation of the periosteum.
• Insect or animal bites: Bites from insects or animals can cause localized inflammation and swelling, which may be mistaken for orbital periostitis.

It's also worth noting that orbital periostitis can be a manifestation of underlying systemic conditions, such as:

• Hypertrophic osteoarthropathy (HOA): A rare condition characterized by clubbing of the fingers, periostitis of the long bones, and arthritis.
• Wegener's granulomatosis: A rare autoimmune disorder that can cause inflammation in various parts of the body, including the orbit.

To accurately diagnose orbital periostitis, a comprehensive medical history, physical examination, and imaging studies (such as CT or MRI scans) are essential. In some cases, a biopsy may be necessary to rule out other conditions.

References:

• [4] Diagnosis of preseptal cellulitis and orbital cellulitis is primarily clinical. Other disorders to consider include trauma, insect or animal bites without ...
• [12] Orbital periostitis: unilateral upper and/or lower eyelid swelling; erythema; ocular motility painful and restricted, but possible; exophthalmos ...