Critical role of STIR MRI in early detection of post-streptococcal periostitis with dysproteinaemia (Goldbloom's syndrome).

Abstract

OBJECTIVES:

In 1966, Goldbloom et al. described two children who developed a peculiar clinical picture characterized by intermittent daily bone pain in the lower limbs, fever spikes, increased acute phase reactants and dysproteinaemia. The syndrome occurred two weeks after a group A β-haemolytic streptococcus infection. So far, only a few cases have been reported in the medical literature in English.

METHODS:

We report two further cases of Goldbloom's syndrome with a review of the literature in English.

RESULTS:

Our two patients lived in the same Italian region and presented their syndrome onset a week apart. Early use of STIR MRI revealed an atypical metaphyseal hyperintensity in the femurs and tibias. X-ray showed periosteal hyperostosis. A short cycle of corticosteroids led to rapid recovery of symptoms and disappearance of bone changes.

CONCLUSIONS:

The reported cases highlight a likely under-recognised post-streptococcal inflammatory periosteal reaction and emphasise the diagnostic utility of the newer imaging modalities.

• Authors: Riccardo Papa, Alessandro Consolaro, Francesca Minoia, Roberta Caorsi, Gianmichele Magnano, Marco Gattorno, Angelo Ravelli, Paolo Picco
• Journal: Clinical and experimental rheumatology (Clin Exp Rheumatol) 2017 May-Jun Vol. 35 Issue 3 Pg. 516-517 ISSN: 0392-856X [Print] Italy
• PMID: 28339360 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Adrenal Cortex Hormones
• Biomarkers
• Prednisone

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Biomarkers (blood)
• Child
• Early Diagnosis
• Female
• Femur (diagnostic imaging, microbiology)
• Humans
• Hypergammaglobulinemia (blood, diagnosis, drug therapy, microbiology)
• Hypoalbuminemia (blood, diagnosis, drug therapy, microbiology)
• Magnetic Resonance Imaging
• Periostitis (diagnostic imaging, drug therapy, microbiology)
• Predictive Value of Tests
• Prednisone (therapeutic use)
• Streptococcal Infections (complications, diagnosis, microbiology)
• Syndrome
• Tibia (diagnostic imaging, microbiology)
• Treatment Outcome