Periosteal Bone Growth in Normal Infants

Nonspecific Infection in Paleopathology: Interpreting Periosteal Reactions

“…venous stasis; 4. an irregular osseous excrescence with a spiculated contour that merges with the underlying cortex, as seen in thyroid acropachy or primary hypertrophic osteoarthropathy; 5. a thin, linear osseous deposit that extends in a direction perpendicular to the underlying cortex, as seen in Ewing's sarcoma; 6. a sunburst pattern, in which linear deposits fan out from a single focus, as seen in osteosarcoma; and 7. a Codman's triangle, consisting of a triangular elevation of the periosteum with one or more layers of new bone, as often seen in various malignant lesions. Periosteal new bone production is also germane to pediatric radiology, as incidental observation of periosteal new bone on long bones is not uncommon (Shopfner 1966). In a study of 335 full-term and 75 premature infants, 115 (35 percent) and 75 (34 percent) respectively, had bilateral periosteal new bone present on the femora, humeri, tibiae, ulnae, and radii, and fibulae (in order of frequency).…”

“…This increased periosteal activity may occur following asynchrony in growth rates of the physis cartilage and the periosteum, resulting in periosteal tension and periosteal new bone production (Jones, personal communication in Scheuer and Black 2000). Shopfner (1966) cautioned that proliferative periosteal reactions seen on the long bones of infants between the ages of 1 and 6 months were not rare or abnormal, and stated that normal periosteal bone growth may have been wrongly described as components of some diseases. Several researchers in paleopathology have heeded this message, with Mann and Murphy (1990) cautioning that the rapidly growing bones of infants, children, and adolescents can mimic periosteal new bone production.…”

“…The warnings issued by Shopfner (1966) and his like-minded successors have important implications for the interpretation of pathology in juvenile skeletal remains. For example, in their analysis of the age distribution of periosteal reactions at the Libben site, Mensforth et al (1978) state that the highest frequency of unremodeled lesions (those consisting of woven bone) occurred in infant skeletons less than 1 year of age.…”

A Study of Non-specific Stress Indicators and Skeletal Growth in Two Mediaeval Subadult Populations

“…They have been related to more than one disease process in past studies (infections, haematopoietic, metabolic and neoplastic disorders or even trauma). Infants, who have a fragile periosteum which is very vascular and loosely bound, are especially more susceptible to non-specific bacterial infections (Shopfner, 1966) and subsequent new bone formation. Subperiosteal new bone formation was scored in six degrees of severity from two reviewed scales of Bell (1987) and Stothers & Metress (1975).…”

A study of nonspecific skeletal health indicators in two nonadult populations from western Britain

“…It is recognised as the deposition of a layer of new bone under an infl amed periosteum as a result of injury or infection (Lewis, 2000). However, the interpretation of periosteal new bone formation can be problematic, particularly on the remains of infants (especially between 1 and 6 months) and children, where it can be misinterpreted as disease when the deposition of immature bone on the cortical surface is the result of normal appositional bone growth (Shopfner, 1966;Mann and Murphy, 1990). …”