Polyarteritis nodosa with new bone formation.

Polyarteritis nodosa was first described as a clinico-pathological entity by Kussmaul and Maier ( 1866), who called it periarteritis nodosa. Ferrari (1903) first called the disease polyarteritis nodosa, a name that describes the pathology more accurately. The disease may be grouped with the collagen diseases-desseminated lupus erythematosis, scleroderma, rheumatoid arthritis and others. It is characteris#{233}d by patches of acute inflammation, necrosis of cells and fibrinoid changes in the collagen fibres of small and mediumsized arteries. The symptoms depend either on ischaemic changes in the tissues supplied by the affected vessels or to rupture of vessels. It is not surprising, therefore, that symptoms referable to practically every system and organ have been described alone or in combination. It is the presentation of symptoms from disease processes involving many systems in a bizarre fashion that usually suggests the possibility of the diagnosis. Arthralgia is common but arthritis rare (Lowman 1952). The medical literature is well reviewed in English by Curtis and Coffey (1934), Harris, Lynch and O’Hare (1939), Miller and Daley (1946) and Nuzum and Nuzum (1954). None refers to affection of bone in this disease. The opportunity is taken of reporting a case of polyarteritis nodosa, the presenting and only symptoms of which were pain and swelling of the shins with subperiosteal new bone formation. Investigations including biopsy are recorded, as well as the response to treatment.