CTICasesVoriconazole-induced periostitis
Imaging findings
Shoulder radiographs show bilateral, symmetric, feathery periosteal reaction and ossification surrounding the clavicles, scapulae, and humeral shafts, which developed in an immunocompromised patient on long-term voriconazole therapy. Shoulder MRI confirmed associated joint effusion.
Key takeaways
Voriconazole-induced periostitis is a painful complication of long-term voriconazole therapy, primarily seen in immunocompromised patients. It is caused by fluoride toxicity (as voriconazole is high in fluoride), resulting in symmetric, feathery periosteal bone formation that typically resolves upon drug discontinuation.
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