Subperiosteal abscess

A 34-year-old woman who had taken intranasal metamfetamine weekly for 15 years developed osteomyelitis of the frontal bone and a subperiosteal abscess. The authors proposed that this was due to chronic abuse of metamfetamine (80). 

A rare case of Pott s puffy tumor, anterior extension of a frontal sinus infection that results in frontal bone osteomyelitis and subperiosteal abscess, has been associated with metamfetamine use (81). 

In adults, the periosteum is tightly bound, and the cortex is thick. These anatomic features generally cause the infections to remain intramedullary. As expected, subperiosteal abscess formations are less common in this population. The infection may spread to adjacent bone structures through the Haversian and Volkmann canals. Chronic osteomyehtis is more likely to occur if large segments of bone become avascular and necrotic. 

Fig. 8.16. Periostitis ofthe tibia. Axial T2 fast spin echo fat saturated image. The child had sustained an open injury 4 months previously when he ran into a bush. The tibia has a low signal thickened cortex. There is extensive high/intermediate signal fluid collection surrounding almost the entire circumference of the tibia, as well as extensive subcutaneous oedema. At surgery, there was shown to be a large subperiosteal abscess...

Kaiser S, Rosenborg M (1994) Early detection of subperiosteal abscesses by ultrasonography a means for further successful treatment in pediatric osteomyelitis. Pediatr Radiol 24 336-339... 

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