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Chronic Osteomyelitis with Proliferative Periostitis (Garre's Osteomyelitis)

 

Definition

Garre's osteomyelitis mainly involves the periosteum and exhibits reactive periosteal osteogenesis in response to low-grade infection or trauma. The condition was first authentically reported in 1893 by German physician C. Garre and it is characterized by focal gross thickening of the involved bone due to subperiosteal new bone deposition (duplication of the cortex).

Pathogenesis

It is usually believed that a low-grade, sustained infection of the jaw bone, occurring in a young person with high degree of body resistance and excellent tissue reactivity, may often precipitate Garre's osteomyelitis.

Clinical Features

•            Age: Children and young adults (mean age is 13 years).

•            Sex: There is no sex predilection.

•            Site: Mandible is commonly involved in Garre's osteomyelitis in its posterior part. Maxilla can be affected on rare occasion.

 

The affected periosteum forms several layers of reactive vital bone and as a result the expanded cortex of bone radiographically exhibits many

concentric or parallel opaque layers, which often produce a typical "onion skin" appearance.

 

Key concept:

Clinical Features of Garre's osteomyelitis

•            Age: Children and young adults (mean age is 13 years).

•            Sex: There is no sex predilection.

•            Site: Mandible is commonly involved in Garre's osteomyelitis in its posterior part. Maxilla can be affected on rare occasion.

The affected periosteum forms several layers of reactive vital bone and as a result the expanded cortex of bone radiographically exhibits many concentric or parallel opaque layers, which often produce a typical "onion skin" appearance.