Critical role of STIR MRi in early detection of post-streptococcal periostitis with dysproteinaemia (Goldbloom's syndrome)
Papa, R.; Consolaro, A.; Minoia, F.; Caorsi, R.; Magnano, G.; Gattorno, M.; Ravelli, A.; Picco, P.
Clinical and Experimental Rheumatology 35(3): 516-517
2017
ISSN/ISBN: 0392-856X PMID: 28339360 Document Number: 694064
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. We report two further cases of Goldbloom's syndrome with a review of the literature in English. 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. The reported cases highlight a likely under-recognised post-streptococcal inflammatory periosteal reaction and emphasise the diagnostic utility of the newer imaging modalities.