Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (984 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
Inflammation of the periosteum. The condition is generally chronic, and is marked by tenderness and swelling of the bone and an aching pain. Acute periostitis is due to infection, is characterized by diffuse suppuration, severe pain, and constitutional symptoms, and usually results in necrosis. (Dorland, 27th ed)
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Periostitides.
Where it fits in the MeSH classification
- Broader topics
- Bone Diseases, Infectious
Research landscape
PubMed indexes 1,050 records tagged with the MeSH heading “Periostitis” (counts retrieved 2026-10-29). 48 of them (4.6%) were published from 2020 onward, and the busiest period so far is through 1999 with 739 records.
Reviews account for 60 records (5.7%) and meta-analyses for 0. Randomized controlled trials number 1 (0.1%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 739 |
| 2000-2009 | 124 |
| 2010-2019 | 139 |
| 2020 onward | 48 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 60 | 5.7% |
| Meta-analyses | 0 | 0.0% |
| Randomized controlled trials | 1 | 0.1% |
Method: PubMed query "Periostitis"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-29.
Reading the evidence in infectious diseases
Infectious disease evidence combines microbiology, epidemiology and clinical trials. Laboratory studies identify pathogens and how they cause harm; surveillance and outbreak investigations describe who is affected and how infection spreads; trials establish whether treatments and vaccines work. Results depend on place and time, because pathogens evolve and resistance patterns and population immunity change. Check when and where the data were collected, how cases were defined and how up to date the evidence is.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
Using disproportionality analysis to explore the association between periostitis and triazole antifungals in the FDA Adverse Event Reporting System Database [1]
Abstract reading summary — source excerpts
- Opening excerpt
- Though triazole antifungals are the first choice for preventing and treating invasive fungal infections, periostitis caused by voriconazole has been described in emerging case reports; however, no studies exist on this association in real-world clinical settings.
- Closing excerpt
- Alternative treatment with other triazole antifungals can be considered, and causality needs to be verified in further prospective studies.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (235 words)
Though triazole antifungals are the first choice for preventing and treating invasive fungal infections, periostitis caused by voriconazole has been described in emerging case reports; however, no studies exist on this association in real-world clinical settings. Our study aimed to identify the association between periostitis and triazole antifungals by analyzing data from the FDA Adverse Event Reporting System (FAERS). We extracted and analyzed reports on the association between periostitis and triazole antifungals in FAERS from the first quarter of 2004 to the second quarter of 2022 using OpenVigil 2.1. Disproportionality analysis was performed to evaluate the association between periostitis and triazole antifungals, and chi-squared (χ2), relative reporting ratio (RRR), reporting odds ratio (ROR), proportional reporting ratio (PRR), and Bayesian confidence propagation neural networks (BCPNN) of information components (IC) were reported. In total, 143 patients experienced periostitis while using voriconazole. Disproportionality analysis identified an association between periostitis and voriconazole (χ2 = 82,689.0, RRR = 583.6, 95%CI [472.4, 721.1], PRR = 1808.9, 95%CI [1356.0, 2412.9], ROR = 1831.7, 95%CI [1371.6, 2446.3], IC = 9.2, 95%CI [8.6, 9.8]). However, no safety signals were observed between periostitis and other triazole antifungals. When stratified by sex and age, disproportionality analysis identified positive signals between periostitis and voriconazole. The possible association between periostitis and voriconazole should attract sufficient attention in clinical practice. Alternative treatment with other triazole antifungals can be considered, and causality needs to be verified in further prospective studies.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 36934109 · DOI · PMC10024698
Increasing high-sensitive C-reactive protein level predicts peritonitis risk in chronic peritoneal dialysis patients [2]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundThe aim of this study was to evaluate whether a high baseline level of high-sensitivity C-reactive protein (hs-CRP) or changes in the level predicts the risk of peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD).
- Closing excerpt
- Progressive rather than persistently high levels of serum hs-CRP predicted peritonitis risk in CAPD patients.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (215 words)
BackgroundThe aim of this study was to evaluate whether a high baseline level of high-sensitivity C-reactive protein (hs-CRP) or changes in the level predicts the risk of peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD).MethodsA prospective, cross-sectional, case-control study was conducted in a single hospital-based PD unit. A total of 327 patients were included in the study. Serum hs-CRP was measured annually for 2 years. Patients were divided into 4 groups according to the changes in annual hs-CRP levels (at baseline and at 1 year intervals): group 1 (from ResultsThe initial serum albumin level was similar in the 4 groups (p = 0.12). There was a negative linear correlation between the serial albumin change (∆alb) and serial hs-CRP change (∆hs-CRP; r = -0.154, p = 0.005). The hazard ratio (HR) for peritonitis was significantly higher in group 2 (HR = 1, reference) than in group 4 (HR = 0.401, 95% CI 0.209 - 0.769). Group 2 had a greater serum albumin decline rate (∆alb: -3% ± 9%) and hs-CRP elevation rate (∆hs-CRP: 835% ± 1232%) compared to those for the other groups.ConclusionsA progressive increase in the hs-CRP level was associated with a corresponding decline in the serum albumin level. Progressive rather than persistently high levels of serum hs-CRP predicted peritonitis risk in CAPD patients.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 24007461 · DOI · PMC3846496
Osteoarchaeological Studies of Human Systemic Stress of Early Urbanization in Late Shang at Anyang, China [3]
Abstract reading summary — source excerpts
- Opening excerpt
- Through the analysis of human skeletal remains and mortuary practice in Yinxu, this study investigates the impact of early urbanization on the commoners during the Late Shang dynasty (ca.
- Closing excerpt
- Our data show that the non-elite urban population in the capital city of Late Shang Dynasty had experienced extensive stress exposure due to early urbanization with further social stratification only worsening the situation, and eventually contributing to collapse of the Shang Dynasty.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (258 words)
Through the analysis of human skeletal remains and mortuary practice in Yinxu, this study investigates the impact of early urbanization on the commoners during the Late Shang dynasty (ca. 1250-1046 B.C.). A total of 347 individuals examined in this study represent non-elites who were recovered from two different burial contexts (formally buried in lineage cemeteries and randomly scattered in refuse pits). Frequencies of enamel hypoplasia (childhood stress), cribra orbitalia (childhood stress and frailty) and osteoperiostitis (adult stress) were examined to assess systemic stress exposure. Our results reveal that there was no significant difference in the frequency of enamel hypoplasia between two burial groups and between sexes, suggesting these urban commoners experienced similar stresses during childhood, but significantly elevated levels of cribra orbitalia and osteoperiostitis were observed in the refuse pit female cohort. Theoretically, urbanization would have resulted in increased population density in the urban centre, declining sanitary conditions, and increased risk of resource shortage. Biologically, children would be more vulnerable to such physiological disturbance; as a result, high percentages of enamel hypoplasia (80.9% overall) and cribra orbitalia (30.3% overall) are observed in Yin commoners. Adults continued to suffer from stress, resulting in high frequencies of osteoperiostitis (40.0% total adults); in particular, in the refuse pit females who may also reflect a compound impact of gender inequality. Our data show that the non-elite urban population in the capital city of Late Shang Dynasty had experienced extensive stress exposure due to early urbanization with further social stratification only worsening the situation, and eventually contributing to collapse of the Shang Dynasty.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 27050400 · DOI · PMC4822842
Periostitis of the Pubic Symphysis in Inguinal and Femoral Hernia: An Uninterpreted Source of Chronic Groin Pain [4]
Abstract reading summary — source excerpts
- Opening excerpt
- Background and Objectives: Severe chronic postoperative inguinal pain (CPIP) affects 2-5% of patients after hernia repair, yet most published explanations remain neuropathic.
- Closing excerpt
- This design would show whether periosteal findings identify a distinct pain phenotype and whether penetrating fixation modifies its course.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (276 words)
Background and Objectives: Severe chronic postoperative inguinal pain (CPIP) affects 2-5% of patients after hernia repair, yet most published explanations remain neuropathic. The pubic periosteum, including the tubercle and adjacent symphyseal zone, lies within the operative field and may be engaged by medial mesh fixation. Its contribution to CPIP has not been tested. This narrative review brings together anatomical, imaging and clinical evidence and defines a hypothesis that can be examined prospectively. Materials and Methods: PubMed/MEDLINE, Embase and the Cochrane Library were searched without date restriction, with the final search run in April 2026. Thirty-three publications met the eligibility criteria. Evidence was classified using the 2011 OCEBM Levels of Evidence, with indirectness recorded when the population, exposure or outcome did not match the review question. The review was narrative, so no PRISMA flow diagram or formal risk-of-bias assessment was undertaken. Results: Direct evidence is limited. Among 1633 patients in one retrospective study, six underwent reoperation for severe late pain, and two had a staple placed in the periosteum. Pain resolved after staple removal. Two further cases of MRI-confirmed osteitis pubis followed laparoscopic repair with a titanium tacker. CT found pubic spurs in 17 of 20 patients, although their clinical meaning was uncertain. Fixation trials, CPIP reviews and groin-pain imaging studies repeatedly examined adjacent outcomes but did not define a periosteal endpoint. Conclusions: Pubic periosteal pathology is a plausible and testable pain generator, not an established cause of CPIP. Prospective studies should pair preoperative MRI and standardised pain mapping with explicit recording of fixation at the pubic tubercle. This design would show whether periosteal findings identify a distinct pain phenotype and whether penetrating fixation modifies its course.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 42796364 · DOI · PMC13608966
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Microbiology and antimicrobial treatment of orbital and intracranial complications of sinusitis in children and their management [5]
- Research article A retrospective comparison of endoscopic plantar fasciotomy to open plantar fasciotomy with heel spur resection for chronic plantar fasciitis/heel spur syndrome [6]
- Research article Periosteum: characteristic imaging findings with emphasis on radiologic-pathologic comparisons [7]
- Research article Periostitis and hypertrophic pulmonary osteoarthropathy: report of 2 cases and review of the literature [8]
- Research article Medication-induced periostitis in lung transplant patients: periostitis deformans revisited [9]
- Research article Chronic osteomyelitis with proliferative periostitis of the mandibular body: report of a case and review of the literature [10]
References
- Li H, Zhang M, Jiao X, Zhu Y, Liu Y, Zeng L, et al.. Using disproportionality analysis to explore the association between periostitis and triazole antifungals in the FDA Adverse Event Reporting System Database. . 2023. PMID 36934109 · DOI · PMC10024698
- Su YJ, Liao SC, Cheng BC, Hwang JC, Chen JB. Increasing high-sensitive C-reactive protein level predicts peritonitis risk in chronic peritoneal dialysis patients. . 2013. PMID 24007461 · DOI · PMC3846496
- Zhang H, Merrett DC, Jing Z, Tang J, He Y, Yue H, et al.. Osteoarchaeological Studies of Human Systemic Stress of Early Urbanization in Late Shang at Anyang, China. . 2016. PMID 27050400 · DOI · PMC4822842
- Muraviev SY, Akulov ZA, Sukhanova MA, Pilipenko MO, Tarabrin EA, Berikkhanov ZGM, et al.. Periostitis of the Pubic Symphysis in Inguinal and Femoral Hernia: An Uninterpreted Source of Chronic Groin Pain. . 2026. PMID 42796364 · DOI · PMC13608966
- Brook I. Microbiology and antimicrobial treatment of orbital and intracranial complications of sinusitis in children and their management. Int J Pediatr Otorhinolaryngol. 2009. PMID 19249108 · DOI
- Tomczak RL, Haverstock BD. A retrospective comparison of endoscopic plantar fasciotomy to open plantar fasciotomy with heel spur resection for chronic plantar fasciitis/heel spur syndrome. J Foot Ankle Surg. 1995. PMID 7550197 · DOI
- Bisseret D, Kaci R, Lafage-Proust MH, Alison M, Parlier-Cuau C, Laredo JD, et al.. Periosteum: characteristic imaging findings with emphasis on radiologic-pathologic comparisons. Skeletal Radiol. 2015. PMID 25269751 · DOI
- Yao Q, Altman RD, Brahn E. Periostitis and hypertrophic pulmonary osteoarthropathy: report of 2 cases and review of the literature. Semin Arthritis Rheum. 2009. PMID 18760449 · DOI
- Chen L, Mulligan ME. Medication-induced periostitis in lung transplant patients: periostitis deformans revisited. Skeletal Radiol. 2011. PMID 20652242 · DOI
- Liu D, Zhang J, Li T, Li C, Liu X, Zheng J, et al.. Chronic osteomyelitis with proliferative periostitis of the mandibular body: report of a case and review of the literature. Ann R Coll Surg Engl. 2019. PMID 30855166 · DOI · PMC6513367
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-29.
See how EvidenceLib is built. Spotted an error? Email support@evidencehelix.com.
Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.