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Periostitis as the initial manifestation of systemic vasculitis

The greatest challenge in diagnosing vasculitis is the diversity of its clinical presentation. Awareness of the heterogeneity of uncommon manifestations can be decisive for the course of the disease.

We report on a patient presenting with periostitis as the initial manifestation of systemic vasculitis. A 38 year old female patient complained about progressively painful swelling and reddening of the distal right lower leg for several weeks. The patient had been healthy until then and had no history of arterial or venous insufficiency. She presented at hospital with reduced pulses and a severe compartment syndrome of the tibialis anterior compartment. An x ray examination showed typical signs of periostitis …