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

Riccardo Papa; Alessandro Consolaro; Francesca Minoia; Roberta Caorsi; Gian Michele Magnano; Marco Gattorno; Angelo Ravelli; Paolo Picco

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

Riccardo Papa, Alessandro Consolaro, Francesca Minoia, Roberta Caorsi, Gian Michele Magnano, Marco Gattorno, Angelo Ravelli, Paolo Picco

Istituto "Giannina Gaslini"

Research output: Contribution to journal › Review article › peer-review

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.

Original language	English
Pages (from-to)	516-517
Number of pages	2
Journal	Clinical and Experimental Rheumatology
Volume	35
Issue number	3
Publication status	Published - Mar 25 2017

Keywords

Adrenal Cortex Hormones
Biomarkers
Child
Early Diagnosis
Female
Femur
Humans
Hypergammaglobulinemia
Hypoalbuminemia
Magnetic Resonance Imaging
Periostitis
Predictive Value of Tests
Prednisone
Streptococcal Infections
Syndrome
Tibia
Treatment Outcome
Case Reports
Journal Article
Review

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Critical role of STIR MRI in early detection of post-streptococcal periostitis with dysproteinaemia (Goldbloom's syndrome). / Papa, Riccardo; Consolaro, Alessandro ; Minoia, Francesca ; Caorsi, Roberta ; Magnano, Gian Michele ; Gattorno, Marco ; Ravelli, Angelo ; Picco, Paolo.

In: Clinical and Experimental Rheumatology, Vol. 35, No. 3, 25.03.2017, p. 516-517.

Research output: Contribution to journal › Review article › peer-review

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title = "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.",

keywords = "Adrenal Cortex Hormones, Biomarkers, Child, Early Diagnosis, Female, Femur, Humans, Hypergammaglobulinemia, Hypoalbuminemia, Magnetic Resonance Imaging, Periostitis, Predictive Value of Tests, Prednisone, Streptococcal Infections, Syndrome, Tibia, Treatment Outcome, Case Reports, Journal Article, Review",

author = "Riccardo Papa and Alessandro Consolaro and Francesca Minoia and Roberta Caorsi and Magnano, {Gian Michele} and Marco Gattorno and Angelo Ravelli and Paolo Picco",

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T1 - Critical role of STIR MRI in early detection of post-streptococcal periostitis with dysproteinaemia (Goldbloom's syndrome)

AU - Papa, Riccardo

AU - Consolaro, Alessandro

AU - Minoia, Francesca

AU - Caorsi, Roberta

AU - Magnano, Gian Michele

AU - Gattorno, Marco

AU - Ravelli, Angelo

AU - Picco, Paolo

PY - 2017/3/25

Y1 - 2017/3/25

N2 - 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.

AB - 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.

KW - Adrenal Cortex Hormones

KW - Biomarkers

KW - Child

KW - Early Diagnosis

KW - Female

KW - Femur

KW - Humans

KW - Hypergammaglobulinemia

KW - Hypoalbuminemia

KW - Magnetic Resonance Imaging

KW - Periostitis

KW - Predictive Value of Tests

KW - Prednisone

KW - Streptococcal Infections

KW - Syndrome

KW - Tibia

KW - Treatment Outcome

KW - Case Reports

KW - Journal Article

KW - Review

M3 - Review article

C2 - 28339360

VL - 35

SP - 516

EP - 517

JO - Clinical and Experimental Rheumatology

JF - Clinical and Experimental Rheumatology

SN - 0392-856X

IS - 3

ER -