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inRadiology Periosteal Reaction

Rich S. Rana1 Periosteal reaction results when cortical bone reacts to one of many possible insults. Tu-
Jim S. Wu mor, infection, trauma, certain drugs, and some arthritic conditions can elevate the perioste-
Ronald L. Eisenberg um from the cortex and form various patterns of periosteal reaction (Fig. 1). The appearance
of periosteal reaction is determined by the intensity, aggressiveness, and duration of the un-
Rana RS, Wu JS, Eisenberg RL derlying insult. Moreover, the periosteum in children is more active and less adherent to the
cortex than in adults. Thus, periosteal reaction can occur earlier and appear more aggressive
in children than in adults.
TABLE 1: Types of Periosteal Reaction TABLE 2: Differential Diagnosis of

Periosteal Reaction
Nonaggressive
Thin Arthritis
Solid Psoriatic arthritis
Thick irregular Reactive arthritis
Septated Metabolic
Aggressive Hypertrophic pulmonary osteoarthropathy
Laminated (onionskin) Thyroid acropathy
Spiculated Congenital
Perpendicular/hair-on-end Pachydermoperiostosis
Sunburst Periosteal reaction of newborn
Disorganized Trauma
Codman triangle Stress fracture

Fracture
Drugs
Fluorosis
Keywords: bone, periosteal reaction, periosteum Hypervitaminosis A
DOI:10.2214/AJR.09.3300
Prostaglandins
Tumors
Received July 8, 2009; accepted after revision
July 30, 2009. Osteosarcoma
Ewing’s sarcoma
1
All authors: Department of Radiology, Beth Israel
Deaconess Medical Center, 330 Brookline Ave., Boston, Chondroblastoma
MA 02215. Address correspondence to R. L. Eisenberg Eosinophilic granuloma
(rleisenb@bidmc.harvard.edu).
Osteoid osteoma
WEB Leukemia and lymphoma
This is a Web exclusive article.
Infection
AJR 2009; 193:W259–W272
Genetic
0361–803X/09/1934–W259 Caffey disease
Vascular
© American Roentgen Ray Society
Venous stasis
AJR:193, October 2009 W259

Rana et al.
A B C
D E F
G H I
Fig. 1—Various subtypes of nonaggressive and aggressive periosteal reaction.
A–I, Diagrams show thin (A), solid (B), thick irregular (C), septated (D), laminated (onionskin) (E), perpendicular/
hair-on-end (F), sunburst (G), disorganized (H), and Codman triangle (I) periosteal reactions. (Courtesy of
Larson ME, Boston, MA)
W260 AJR:193, October 2009

Periosteal Reaction
A B
Fig. 2—Solid periosteal reaction (osteoid osteoma).
A, Lateral radiograph reveals thick, smooth periosteal reaction in anterior cortex of distal femur (arrow).
B, Axial CT image shows lucent central nidus (arrow) of osteoid osteoma and thick reactive periosteal reaction
(arrowhead).
Types of Periosteal Reaction

There is confusing overlap in the literature regarding the terminology used to describe
periosteal reaction. It has been classified in terms of continuous versus interrupted forms,
single versus multiple layers, and aggressive versus nonaggressive subtypes. In evaluating
periosteal reaction, the major goal is to recognize its presence rather than the specific subtype
because there is significant overlap in the disease entities that result in the two major forms of
periosteal reaction: aggressive and nonaggressive. In many cases, it is not possible to radio-
graphically determine whether the underlying process is benign or malignant. Processes that
cause rapid deposition of woven bone over a short time can produce aggressive periosteal
reaction, whereas processes that are less intense and progress more slowly produce a nonag-
gressive appearance (Table 1 and Figs. 1A–1I).
Although there is considerable overlap, at times the subtype of periosteal reaction can be sug-
gestive of a certain disease. For example, solid periosteal reaction is a nonaggressive form that
is primarily seen with benign, slow processes. A healed fracture, osteoid osteoma, and osteomy-
elitis can all exhibit solid periosteal reaction that appears as either thin or thick sheets (Fig. 2).
In the laminated subtype of periosteal reaction, multiple layers of new bone are formed
concentrically around the cortex, producing a laminated or onionskin appearance (Fig. 3).
Originally, it was believed that alternating cycles of rapid and slow injury to bone led to the
Fig. 3—Onionskin periosteal reaction (osteomyelitis).

Frontal radiograph shows localized laminated
periosteal reaction (arrow) along lateral cortex of
distal femur.

Rana et al.
Fig. 4—Hair-on-end periosteal reaction (Ewing’s

sarcoma). Lateral radiograph of lower leg shows bony
spicules emanating perpendicular to cortex (arrows).
Fig. 5—Hair-on-end periosteal reaction (chronic

osteomyelitis). Axial CT image of shoulder shows
spiculations (arrows) arising along posterior cortex of
scapula. (Courtesy of Katz L, New Haven, CT)
formation of concentric layers. However, more recent studies suggest that the multiple layers
form because of modulation of sheets of fibroblasts in the adjacent soft tissue, which develop
osteoblastic potential and give rise to sheets of new bone. Another suggested mechanism is
that as the new layer of bone is lifted off the cortex, the inner cambium layer is stimulated to
form a new bone layer below. The laminated appearance is seen in a variety of lesions, includ-
ing sarcomas, osteomyelitis, and chondroblastomas.
The spiculated pattern is an aggressive form of periosteal reaction that includes both hair-
on-end and sunburst subtypes. Spicules of bone form perpendicular to the periosteal surface
in the hair-on-end subtype (Figs. 4 and 5), which is highly suggestive of Ewing’s sarcoma.
The linear spicules of new bone form along newly formed vascular channels and fibrous
bands (Sharpey fibers). In the sunburst subtype of periosteal reaction, the spicules of new
bone radiate in a divergent pattern instead of perpendicular to the cortex (Fig. 6), an appear-
ance often associated with conventional osteosarcomas.
A Codman triangle develops when a portion of periosteum is lifted off of the cortex by
tumor, pus, or hemorrhage at a leading edge (Fig. 7). This aggressive form of periosteal reac-
tion is commonly seen in osteosarcomas and occasionally with infection and metastases.
Differential Diagnosis of Periosteal Reaction

An outline of the differential diagnosis of periosteal reaction is presented in Table 2.
Psoriatic Arthritis
Psoriatic arthritis is a seronegative spondyloarthropathy with inflammatory changes in-
volving the skin and joints. Bone proliferation is an important feature of psoriatic arthritis,
and periostitis can occur along the phalangeal shafts. The periosteal reaction initially is exu-

Periosteal Reaction
A C
Fig. 6—Sunburst periosteal reaction (osteogenic sarcoma complicating long-standing Paget’s disease).
A, Frogleg radiograph of femur shows sunburst and disorganized aggressive periosteal reaction (arrows).
B and C, Axial T2-weighted MR (B) and axial CT (C) images show extensive cortical thickening (arrowheads)
and large soft-tissue mass (arrows) surrounding diaphysis of femur.
berant and fluffy. Later it matures into solid new bone, causing a widened appearance to the
shafts (Fig. 8). Additional radiographic findings include juxtaarticular osteopenia, soft-tissue
swelling, loss of cartilage, and marginal erosions.
Reactive Arthritis
Reactive arthritis is another seronegative spondyloarthropathy, which can occur after a
genital infection (Chlamydia trachomatis, Neisseria gonorrheae) or gastrointestinal infec-
tion (Salmonella, Shigella, or Campylobacter species). Localized periosteal reaction devel-
ops that is indistinguishable from psoriatic arthritis but more commonly affects the lower
extremities (such as the calcaneus and metatarsals). The periosteal reaction may result in
fluffy bone formation along the shaft and metaphyses.
Pachydermoperiostosis
Pachydermoperiostosis is an autosomal-dominant inherited disorder characterized by
marked thickening of the skin of the extremities, face, and scalp. It is also known as primary
hypertrophic osteoarthropathy because it is not due to a secondary cause such as lung disease.
Pachydermoperiostosis is a self-limited disease that most commonly affects adolescent boys
and progresses for several years before stabilizing. The generalized and symmetric periosteal
reaction in pachydermoperiostosis tends to blend with the cortex and primarily involves the
distal ends of the radius, ulna, tibia, and fibula.
Physiologic Periosteal Reaction of the Newborn

Physiologic periosteal reaction of the newborn is typically symmetric and occurs in infants
up to 6 months old, most commonly between 1 and 4 months old. The rapid growth of the
infant and loosely adherent periosteum may account for this finding. The usual appearance is

Rana et al.
Fig. 7—Codman triangle (prostate cancer). Frontal Fig. 8—Psoriatic arthritis. Frontal radiograph of hand
radiograph of distal femur shows edge of periosteum shows thick solid periosteal reaction along proximal
(thin arrow) lifted off cortex (arrowhead) at site of phalanx of long finger (arrows). Marginal erosions
sclerotic metastasis (thick arrow). (Courtesy of Katz are seen at heads of middle and proximal phalanges
L, New Haven, CT) (arrowheads).
a single-layered, thin periosteal reaction (< 2 mm) involving one aspect of the long bones,
especially in the femurs and tibias (Fig. 9).
Fluorosis
Fluorosis is known to stimulate osteoblasts and can cause a solid periosteal reaction, most
often in tubular bones in a symmetric distribution, especially at sites of muscle and ligament
attachment. Associated findings are calcified tendons and ligaments (posterior longitudinal,
iliolumbar, sacrotuberous, and sacrospinous) and dense skeletal sclerosis (most prominent in
vertebrae and the pelvis).
Fig. 9—Physiologic periostitis. Frontal radiograph of both femurs show smooth, single-layer periosteal reaction
on lateral aspects of both femoral shafts (arrows). (Courtesy of Kotecha M, Philadelphia, PA)

Periosteal Reaction
Hypervitaminosis A
Retinoids are commonly used to treat children and teens with severe acne, psoriasis, and
burn injuries. Overuse can lead to hypervitaminosis A, which results in solid periosteal reac-
tion along the long bones, growth retardation, and premature closure of growth plates. The
periosteal reaction occurs greatest near the center of the shaft and tapers toward the ends of
the bone. Unlike Caffey disease, the periosteal reaction rarely involves the mandible. The
ulna, lower leg, metatarsals, and clavicle are the most common locations.
Prostaglandins
Prostaglandins can be used to maintain the patency of the ductus arteriosus in infants with
congenital heart disease and ductal-dependent physiology. They are believed to decrease os-
teoclast bone resorption, which can result in periosteal reaction associated with limb pain and
considerable swelling of the extremities, all of which improve after cessation of the drug.
Infection
Osteomyelitis can cause localized periosteal reaction anywhere but primarily causes this
appearance in the long bones. Subperiosteal spread of inflammation elevates the periosteum
and stimulates the laying down of layers of new bone parallel to the shaft. Eventually, a large
amount of new bone surrounds the cortex in a thick irregular bony sleeve (involucrum) (Fig.
Fig. 10—Chronic osteomyelitis. Lateral radiograph Fig. 11—Caffey disease. Lateral radiograph of lower
of distal femur shows dense thick periosteal reaction leg of 2-month-old girl with left lower extremity pain
(involucrum, straight arrows) surrounding dead shows extensive thick periosteal reaction along tibia
bone (sequestrum, arrowheads). (Reprinted with and fibula (arrows).
permission from Eisenberg RL. Clinical imaging: an
atlas of differential diagnosis, 4th ed. Philadelphia,
PA: Lippincott Williams & Wilkins, 2003)

Rana et al.
10). Disruption of the cortical blood supply leads to bone necrosis with dense segments of
avascular dead bone (sequestra) remaining. Among the many subtypes of periosteal reaction
that can occur with infection are disorganized, thin, lamellated, or spiculated forms. A Cod-
man triangle can also develop, often with lytic destruction of bone in the acute phase.
Caffey Disease
Caffey disease, also known as infantile cortical hyperostosis, is a rare self-limiting inflam-
matory disease of infancy that is characterized by hyperirritability, soft-tissue swelling, and
cortical hyperostosis and particularly involves the mandible and facial bones. The disease is
believed to be an autosomal-dominant disease related to type 1 collagen mutation. Caffey dis-
ease almost always occurs before 6 months and is characterized by a laminated periosteal reac-
tion affecting the mandible, scapula, clavicle, and ulna and, less frequently, the ribs (Fig. 11).
Hypertrophic Pulmonary Osteoarthropathy

Hypertrophic pulmonary osteoarthropathy is a common cause of periosteal reaction in
adults that is associated with many underlying malignancies or chronic diseases. It most fre-
quently arises in patients with primary intrathoracic neoplasms, especially non–small cell
lung cancer. Other common causes include tumors of the pleura and mediastinum, chronic
A B
Fig. 12—Secondary hypertrophic osteoarthropathy.

A and B, Bilateral frontal views of distal femur show
thin and thick single layer periosteal reaction (arrows)
along femoral shafts bilaterally.
C, Frontal chest radiograph shows right upper lobe
masses from non–small cell lung cancer (arrows).
C

Periosteal Reaction
suppurative lung lesions (lung abscess, bronchiectasis, and empyema), cystic fibrosis, and
pulmonary metastases in infants and children. It occasionally occurs in association with ex-
trathoracic neoplasms and gastrointestinal diseases (biliary cirrhosis, ulcerative colitis, and
Crohn’s disease).
Because hypertrophic osteoarthropathy is systemically mediated, although through an un-
known mechanism, it typically produces periosteal reaction that is symmetric and widely
distributed (Figs. 12 and 13). It typically involves the diaphyses of tubular bones, sparing the
ends. There can be associated clubbing of the fingers and toes and often enlargement of the
extremities and swollen joints.
Thyroid Acropachy
Thyroid acropachy is a rare complication of autoimmune thyroid disease that is character-
ized by progressive exophthalmus, relatively symmetric swelling of the hands and feet, club-
bing of the digits, and pretibial myxedema. It can develop after thyroidectomy or radioactive
iodine treatment of primary hyperthyroidism, with most patients being euthyroid or hypothy-
roid when symptoms develop. Thyroid acropachy produces generalized and symmetric spicu-
lated periosteal reaction that primarily involves the midportions of the diaphyses of tubular
bones of the hands and feet.
Stress Fracture
Stress fractures can show subtle solid periosteal reaction in the region of pain or trauma.
Abnormalities are seen earlier on MR images than on radiographs, with bone marrow edema
and increased signal in the muscles and periosteum on T2-weighted images. Common sites of
stress fracture include the tibias, metatarsals, long bones, pelvis, and calcaneus.
A B
Fig. 13—Hypertrophic pulmonary osteoarthropathy.

A and B, Frontal radiographs of both hands show
thick, fluffy, symmetric periosteal reaction along
shafts of several metacarpals and phalanges (arrows).
C, Radionuclide bone scan shows increased
radiotracer uptake bilaterally at sites of periosteal
reaction.
C

Rana et al.
Fracture
Periosteal reaction related to fractures can show a solid, nonaggressive appearance or a
more disorganized, aggressive appearance (Fig. 14). A fracture occurring at a site involved in
a greater degree of motion may produce a more disorganized pattern of periosteal reaction.
Periosteal reaction from traumatic and pathologic fractures can have a similar appearance. In
addition, there may be a related soft-tissue mass on radiographs, which should be followed up
to confirm resolving hematoma.
Osteosarcoma
Conventional osteosarcomas are common high-grade intramedullary neoplasms that pro-
duce an osteoid matrix. The majority of lesions occur in patients under 25 years old , with the
femur, tibia, and fibula the most common sites. The sunburst, hair-on-end, or Codman trian-
gle subtypes of periosteal reaction are most frequently seen (Fig. 15). However, laminated,
solid, thin, or disorganized forms of periosteal reaction can also be present. A wide zone of
transition, cortical breakthrough, and soft-tissue mass are all concerning features that war-
rant further evaluation.
Ewing’s Sarcoma
Ewing’s sarcoma is derived from undifferentiated mesenchymal cells of bone marrow or
primitive neuroectodermal cells and accounts for 6–8% of primary malignant bone tumors.
Although characteristically intramedullary in location, on radiographs, only the cortical
changes may be apparent with a permeative or moth-eaten osteolytic component. A large soft-
tissue mass can be seen. The periosteal reaction pattern is typically aggressive, with the hair-
on-end subtype highly characteristic for Ewing’s sarcoma.
Chondroblastoma
Chondroblastomas are benign cartilage-producing lesions that typically occur in the epiphy-
ses of skeletally immature patients. The lesions are typically lytic and may have a sclerotic
A B
Fig. 14—Fracture.
A, Frontal radiograph obtained 7 days after injury shows disorganized aggressive periosteal reaction at site of
fracture (arrow) involving neck of third metatarsal.
B, Repeat radiograph obtained 4 weeks after injury shows smooth, thin, nonaggressive periosteal reaction at
same site (arrow), consistent with healing.

Periosteal Reaction
Fig. 15—Osteogenic sarcoma. Lateral radiograph Fig. 16—Chondroblastoma. Radiograph shows

of mid femur shows sunburst periosteal reaction laminated (arrow) and disorganized periosteal
with bone formation in divergent pattern (arrow). reaction along proximal humerus.
(Courtesy of Haims A, New Haven, CT)
margin. Periosteal reaction due to chondroblastoma most commonly occurs in large lesions in
flat or small tubular bones. The periosteal reaction can be thick, solid, or laminated (Fig. 16).
Eosinophilic Granuloma
Eosinophilic granuloma is the benign form of the three clinical variants of Langerhans cell
histiocytosis (the others are Letterer-Siwe and Hand-Schüller-Christian diseases). Neoplastic
proliferation of Langerhans cells present predominantly as lytic lesions. However, there may
be sclerotic areas with a thick or laminated pattern of periosteal reaction, especially during
the healing phase. This appearance can be mistaken for osteomyelitis.
Osteoid Osteoma
Osteoid osteoma is a benign bone-forming tumor affecting children and adolescents, most
commonly occurring in the femur, tibia, fibula, or humerus. A thick and dense periosteal re-
action develops as a response to the tumor. The central lucent nidus may be difficult to visual-
ize on radiographs, and CT can be helpful in these instances (Fig. 17). Subperiosteal osteoid
osteomas can produce extensive aggressive periosteal reaction, whereas intraarticular lesions
typically cause relatively little periosteal new bone formation.
Leukemia and Lymphoma

Both leukemia and lymphoma can be associated with an aggressive-appearing periosteal
reaction. In children, leukemia is more likely to affect long bones, whereas in adults, the axial
skeleton is more commonly affected. A thin or laminated pattern of periosteal reaction is com-
mon (Fig. 18), with a hair-on-end appearance less frequent. Lymphoma may produce an aggres-
sive and disorganized periosteal reaction, and there may be an associated soft-tissue mass that
is larger than the area of bone destruction.
Venous Stasis
Venous stasis, especially in the lower extremities, can result in generalized solid undulat-
ing periosteal reaction that initially can be separate from the cortex (Fig. 19). The increase in

Rana et al.
A B
Fig. 17—Osteoid osteoma.
A, Frontal radiograph of proximal tibia shows smooth,
thick periosteal reaction along medial tibia cortex
(arrow).
B and C, Coronal reformatted (B) and axial CT
(C) images show lucent central nidus (arrows)
surrounded by reactive periosteal reaction
(arrowheads).
mean interstitial fluid pressure in venous stasis may exert pressure on the periosteum, leading
to periosteal new bone formation. Although not always present, clues to this diagnosis include
widespread subcutaneous edema and phleboliths in varicose veins.
Unilateral Versus Bilateral Periosteal Reaction

Unilateral periosteal reaction is caused by a localized process, such as trauma, tumor, or
infection. Bilateral periosteal reaction is typically due to systemic processes, and the differ-
ential diagnosis can often be narrowed by patient age and clinical presentation. Before 6
months, the most common causes are physiologic periostitis of the newborn, Caffey disease,
and periostitis related to prostaglandin use. Bilateral periosteal reaction that appears after 6
months should suggest hypertrophic osteoarthropathy, juvenile idiopathic arthritis, hypervi-
taminosis A, and venous stasis. In the appropriate clinical situation, it is essential to consider
nonaccidental trauma resulting in multiple healing fractures as the underlying cause.
Conclusion
Periosteal reaction results from the response of cortical bone to a variety of insults. Recogni-
tion of the presence of periosteal reaction is the most important step. Occasionally, the pattern
of periosteal reaction is highly suggestive of a particular process, but in general there is signifi-

Periosteal Reaction
Fig. 18—Leukemia. Frontal radiograph of femurs Fig. 19—Venous stasis. Periosteal new bone
shows dense thick periosteal reaction along femoral formation cloaks tibia and fibula. (Reprinted with
shafts bilaterally. (Reprinted with permission from permission from Eisenberg RL. Clinical imaging: an
Eisenberg RL. Clinical imaging: an atlas of differential atlas of differential diagnosis, 4th ed. Philadelphia,
diagnosis, 4th ed. Philadelphia, PA: Lippincott PA: Lippincott Williams & Wilkins, 2003)
Williams & Wilkins, 2003)
cant overlap in the disease entities that result in aggressive and nonaggressive forms. Intense,
rapid-acting processes usually result in aggressive periosteal reaction; slower, indolent process-
es result in a nonaggressive form. The causes of periosteal reaction are broad, including trauma,
infection, arthritis, tumors, and drug-induced and vascular entities. When periosteal reaction
occurs in a bilateral distribution, a systemic disease process should be considered.

Rana et al.
Suggested Reading
1. de Silva P, Evans-Jones G, Wright A, Henderson R. Physiological periostitis: a potential pitfall. Arch Dis
Child 2003; 88:1124–1125
2. Greenfield GB, Warren DL, Clark RA. MR imaging of periosteal and cortical changes of bone. Radio-
Graphics 1991; 11:611–623; discussion 624
3. Gross M, Stevens K. Sunburst periosteal reaction in osteogenic sarcoma. Pediatr Radiol 2005; 35:647–648
4. Kwon DS, Spevak MR, Fletcher K, Kleinman PK. Physiologic subperiosteal new bone formation: preva-
lence, distribution, and thickness in neonates and infants. AJR 2002; 179:985–988
5. Letts M, Pang E, Simons J. Prostaglandin-induced neonatal periostitis. J Pediatr Orthop 1994; 14:809–813
6. Resnick DM, Kransdorf MM. Bone and joint imaging, 3rd ed. Richmond, VA: Elsevier Saunders, 2005:1536
7. Vanhoenacker FM, Pelckmans MC, De Beuckeleer LH, Colpaert CG, De Schepper AM. Thyroid acropachy:
correlation of imaging and pathology. Eur Radiol 2001; 11:1058–1062
8. Wenaden AE, Szyszko TA, Saifuddin A. Imaging of periosteal reactions associated with focal lesions of
bone. Clin Radiol 2005; 60:439–456

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A. Toretsky, Yasmin Uhlenbruch, Volker Vieth, Thomas G. P. Grünewald, Uta Dirksen. 2021. Ewing Sarcoma—Diagnosis,
Treatment, Clinical Challenges and Future Perspectives. Journal of Clinical Medicine 10:8, 1685. [Crossref]
26. Amanda N. Goldin, Alok Singh, Shweta Joshi, Christina Jamieson, Donald L. Durden. 2021. Augmented Antitumor Activity
for Novel Dual PI3K/BDR4 Inhibitors, SF2523 and SF1126 in Ewing Sarcoma. Journal of Pediatric Hematology/Oncology 43:3,
e304-e311. [Crossref]
27. Amir Ardakani, Panagiotis Gikas, Michael Khoo, Paul O’Donnell, Roberto Tirabosco, Asif Saifuddin. 2021. MRI-
histopathological correlation in paediatric conventional central chondrosarcoma: a report of 17 cases. Skeletal Radiology 50:4,
711-721. [Crossref]
28. Zita Laffranchi, Marco Milella, Paolo Lombardo, Rupert Langer, Sandra Lösch. 2021. Co-occurrence of malignant neoplasm
and Hyperostosis Frontalis Interna in an Iron Age individual from Münsingen-Rain (Switzerland): A multi-diagnostic study.
International Journal of Paleopathology 32, 1-8. [Crossref]
29. Tito Aureliano, Carolina S.I. Nascimento, Marcelo A. Fernandes, Fresia Ricardi-Branco, Aline M. Ghilardi. 2021. Blood
parasites and acute osteomyelitis in a non-avian dinosaur (Sauropoda, Titanosauria) from the Upper Cretaceous Adamantina
Formation, Bauru Basin, Southeast Brazil. Cretaceous Research 118, 104672. [Crossref]
30. Lucie Biehler-Gomez, Cristina Cattaneo. Infectious Diseases: Non-Specific and Specific Infections 39-67. [Crossref]
31. Pornkawee Charoenlarp, Onanong Silkosessak-Chaiudom, Vichittra Vipismakul. 2021. Atypical periosteal reaction and unusual
bone involvement of ameloblastoma: A case report with 8-year follow-up. Imaging Science in Dentistry 51:2, 195. [Crossref]
32. Iliana Bednarova, Sandra Bednarova. Musculoskeletal and Bone Imaging 203-257. [Crossref]
33. Yen-Lin Tsai, Yen-Ju Chen, Yu-Cheng Lai. 2020. Long-term follow-up of osteomyelitis caused by Bacille Calmette-Guérin
vaccination in immunocompetent children. Scientific Reports 10:1. . [Crossref]
34. J Singh, R Rajakulasingam, A Saifuddin. 2020. Langerhans cell histiocytosis of the shoulder girdle, pelvis and extremities: a
review of radiographic and MRI features in 85 cases. Skeletal Radiology 49:12, 1925-1937. [Crossref]
35. E. L. Trisvetova. 2020. Primary hypertrophic osteoarthropathy. Rheumatology Science and Practice 58:5, 544-549. [Crossref]
36. Mahboube Hasheminasab, Abbas Karimi, Mehdi Kardoust Parizi, Farid Kosari, Amirali Asadi. 2020. Metastasis of a prostate
adenocarcinoma to mandible: A case report and review of literature. Clinical Case Reports 8:10, 2063-2066. [Crossref]
37. Thamer Musbah, Galal Omami. 2020. Ill-defined lytic mandibular lesion. The Journal of the American Dental Association 151:9,
692-695. [Crossref]
38. Alyssa R. Goldbach, Maruti Kumaran, Achala Donuru, Kristen McClure, Chandra Dass, Partha Hota. 2020. The Spectrum
of Rib Neoplasms in Adults: A Practical Approach and Multimodal Imaging Review. American Journal of Roentgenology 215:1,
165-177. [Abstract] [Full Text] [PDF] [PDF Plus]
39. William Palmer, Laura Bancroft, Fiona Bonar, Jung-Ah Choi, Anne Cotten, James F. Griffith, Philip Robinson, Christian
W.A. Pfirrmann. 2020. Glossary of terms for musculoskeletal radiology. Skeletal Radiology 49:S1, 1-33. [Crossref]
40. Sarah A. Jones, Lindsey J. Gilmour, Catherine M. Ruoff, Roy R. Pool. 2020. Radiographic features of histologically benign
bone infarcts and bone infarcts associated with neoplasia in dogs. Journal of the American Veterinary Medical Association 256:12,
1352-1358. [Crossref]
41. Bruce Rothschild, Lyman Jellema. 2020. Periosteal reaction recognition and specificity assessed by surface microscopy.
International Journal of Osteoarchaeology 30:3, 355-361. [Crossref]
42. Marin A. Pilloud, Al W. Schwitalla. 2020. Re-evaluating traditional markers of stress in an archaeological sample from central
California. Journal of Archaeological Science 116, 105102. [Crossref]
43. Benjamin Jentgen-Ceschino, Koen Stein, Valentin Fischer. 2020. Case study of radial fibrolamellar bone tissues in the outer
cortex of basal sauropods. Philosophical Transactions of the Royal Society B: Biological Sciences 375:1793, 20190143. [Crossref]
44. Melissa F. Tannenbaum, Sakura Noda, Sara Cohen, Julia G. Rissmiller, Anna M. Golja, Daniel M. Schwartz. 2020. Imaging
Musculoskeletal Manifestations of Pediatric Hematologic Malignancies. American Journal of Roentgenology 214:2, 455-464.
[Abstract] [Full Text] [PDF] [PDF Plus]
45. Zhendong Luo, Weiguo Chen, Xinping Shen, Genggeng Qin, Jianxiang Yuan, Biying Hu, Jianxun Lyu, Chanjuan Wen, Weimin
Xu. 2020. Head and neck osteosarcoma: CT and MR imaging features. Dentomaxillofacial Radiology 49:2, 20190202. [Crossref]
46. Zhendong Luo, Weiguo Chen, Xinping Shen, Genggeng Qin, Jianxiang Yuan, Biying Hu, Jianxun Lyu, Derun Pan. 2020.
CT and MRI features of calvarium and skull base osteosarcoma (CSBO). The British Journal of Radiology 93:1105, 20190653.
[Crossref]
47. Carlos Henrique Maia Ferreira Alencar, Cláudio Régis Sampaio Silveira, Matheus Martins Cavalcante, Clarissa Gadelha Maia
Vieira, Manoel Joaquim Diógenes Teixeira, Francisco Andrade Neto, Armando de Abreu, Avneesh Chhabra. 2020. “Periosteum:
An imaging review”. European Journal of Radiology Open 7, 100249. [Crossref]
48. Brittany Szabo, Justin Gambini. 2020. Ewing Sarcoma. JBJS Journal of Orthopaedics for Physician Assistants 8:2, e0004-e0004.
[Crossref]
49. Amir Joshi, Gaurav Nepal, Yow Ka Shing, Hari Prasad Panthi, Suman Baral. 2019. Pachydermoperiostosis (Touraine–Solente–
Gole syndrome): a case report. Journal of Medical Case Reports 13:1. . [Crossref]
50. Kimberley Jacobs, David M. Vu, Vidya Mony, Elvera Sofos, Nadav Buzi. 2019. Congenital Syphilis Misdiagnosed as Suspected
Nonaccidental Trauma. Pediatrics 144:4. . [Crossref]
51. Ju Hee Kang, Yu-Kyeong Seo, Sae Rom Lee, Song Hee Oh, Yong-Suk Choi, Eui-Hwan Hwang. 2019. Characteristic imaging
findings of acantholytic squamous cell carcinoma: a case report. Oral Radiology 35:3, 341-346. [Crossref]
52. Sandra Assis, Anne Keenleyside. 2019. The macroscopic and histomorphological properties of periosteal rib lesions and its
relation with disease duration: evidence from the Luis Lopes Skeletal Collection (Lisbon, Portugal). Journal of Anatomy 234:4,
480-501. [Crossref]
53. Antoine Moraux, Salvatore Gitto, Stefano Bianchi. 2019. Ultrasound Features of the Normal and Pathologic Periosteum. Journal
of Ultrasound in Medicine 38:3, 775-784. [Crossref]
54. Fernanda Mombrini Pigatti, Maria Carolina Martins Mussi, Bruno Tavares Sedassari, Priscila Lie Tobouti, Décio dos Santos
Pinto-Junior. 2019. Radiographic aspects of metastatic tumors of the jaw. Oral and Maxillofacial Surgery Cases 5:1, 100097.
[Crossref]
55. Isaiah Tan, Laurie Lomasney, Gregory Scott Stacy, Martin Lazarus, Winnie Anne Mar. 2019. Spectrum of Voriconazole-
Induced Periostitis With Review of the Differential Diagnosis. American Journal of Roentgenology 212:1, 157-165. [Abstract]
[Full Text] [PDF] [PDF Plus]
56. Ioan N. Gemescu, Kolja M. Thierfelder, Christoph Rehnitz, Marc-André Weber. 2019. Imaging Features of Bone Tumors.
Magnetic Resonance Imaging Clinics of North America 27:4, 753. [Crossref]
57. Francesco Bozzao, Stella Bernardi, Franca Dore, Lorenzo Zandonà, Fabio Fischetti. 2018. Hypertrophic osteoarthropathy
mimicking a reactive arthritis: a case report and review of the literature. BMC Musculoskeletal Disorders 19:1. . [Crossref]
58. . The Backbone of Europe 8, . [Crossref]
59. Carina Marques, Vitor Matos, Nicholas J. Meinzer. Proliferative Periosteal Reactions 137-174. [Crossref]
60. Raza Mushtaq, David Nolte, Faryal Shareef, Mihra S Taljanovic. 2018. Diffuse periostitis as the primary presenting radiological
finding in an AML patient with disease relapse. Radiology Case Reports 13:5, 965-969. [Crossref]
61. Rachel Schats, Menno Hoogland, Andrea Waters-Rist. 2018. A probable case of metastatic carcinoma in the medieval
Netherlands. International Journal of Paleopathology 22, 181-188. [Crossref]
62. Rebecca Shen, Zhi Li, Linglin Zhang, Yingqi Hua, Min Mao, Zhicong Li, Zhengdong Cai, Yunping Qiu, Jonathan Gryak,
Kayvan Najarian. Osteosarcoma Patients Classification Using Plain X-Rays and Metabolomic Data 690-693. [Crossref]
63. Anita Gohel, Masafumi Oda, Amol S. Katkar, Osamu Sakai. 2018. Multidetector Row Computed Tomography in Maxillofacial
Imaging. Dental Clinics of North America 62:3, 453-465. [Crossref]
64. Alysha Vartevan, Crystal May, Craig E. Barnes. 2018. Pediatric bone imaging: Differentiating benign lesions from malignant.
Applied Radiology 31, 8-15. [Crossref]
65. David MacDonald, Christos Angelopoulos, William C. Scarfe. 469. [Crossref]
66. Toshiyuki Tsurumoto, Tetsuaki Wakebe, Keiko Ogami-Takamura, Keishi Okamoto, Kazunori Tashiro, Kazunobu Saiki. 2018.
An Ancient Skeleton with Multiple Osteoblastic Bone Lesions Containing a Scapular Sunburst Appearance from a 5th–6th
Century Grave Excavated in Oita, Japan. BioMed Research International 2018, 1. [Crossref]
67. Zhen-An Hwang, Kyung Jin Suh, Dillon Chen, Wing P. Chan, Jim S. Wu. 2018. Imaging Features of Soft-Tissue Calcifications
and Related Diseases: A Systematic Approach. Korean Journal of Radiology 19:6, 1147. [Crossref]
68. Romina Gonzalez, Pablo A. Gallina, Ignacio A. Cerda. 2017. Multiple paleopathologies in the dinosaur Bonitasaura salgadoi
(Sauropoda: Titanosauria) from the Upper Cretaceous of Patagonia, Argentina. Cretaceous Research 79, 159-170. [Crossref]
69. Michiel Croes, Willemijn Boot, Moyo C. Kruyt, Harrie Weinans, Behdad Pouran, Yvonne J.M. van der Helm, Debby Gawlitta,
H. Charles Vogely, Jacqueline Alblas, Wouter J.A. Dhert, F. Cumhur Öner. 2017. Inflammation-Induced Osteogenesis in a
Rabbit Tibia Model. Tissue Engineering Part C: Methods 23:11, 673-685. [Crossref]
70. Anna Rohnbogner. 2017. Listening to the Kids: The Value of Childhood Palaeopathology for the Study of Rural Roman
Britain. Britannia 48, 221-252. [Crossref]
71. Josy Lorena Peres Vilarinho, Nath?lia Ferrare, Andreia Maria Rocha Moreira, Helora Freitas Moura, Ana Carolina Acevedo,
Sacha Braun Chaves, Nilce Santos Melo, Andr? Ferreira Leite, S?rgio Bruzadelli Macedo, Melissa Paoletti de Souza, Ana Tereza
Bittencourt Guimar?es, Paulo Tadeu Figueiredo. 2017. Early bony changes associated with bisphosphonate-related osteonecrosis
of the jaws in rats: A longitudinal in vivo study. Archives of Oral Biology 82, 79-85. [Crossref]
72. Michiel Croes, Willemijn Boot, Moyo C Kruyt, Harrie Weinans, Behdad Pouran, Yvonne van der Helm, Debby Gawlitta,
Charles Vogely, Jacqueline Alblas, Wouter Dhert, F Cumhur Oner. 2017. Inflammation-induced Osteogenesis in a Rabbit Tibia
Model. Tissue Engineering Part C: Methods . [Crossref]
73. José Luiz de Sá Neto, Marcelo Novelino Simão, Michel Daoud Crema, Edgard Eduard Engel, Marcello Henrique Nogueira-
Barbosa. 2017. Diagnostic performance of magnetic resonance imaging in the assessment of periosteal reactions in bone sarcomas
using conventional radiography as the reference. Radiologia Brasileira 50:3, 176-181. [Crossref]
74. Se Kyoung Park, In Sook Lee, Kil Ho Cho, Young Hwan Lee, Jae Hyuck Yi, Kyung Un Choi. 2017. Osteosarcoma of pelvic
bones: imaging features. Clinical Imaging 41, 59-64. [Crossref]
75. Felix Y. Yap, Matthew R. Skalski, Dakshesh B. Patel, Aaron J. Schein, Eric A. White, Anderanik Tomasian, Sulabha Masih,
George R. Matcuk. 2017. Hypertrophic Osteoarthropathy: Clinical and Imaging Features. RadioGraphics 37:1, 157-195.
[Crossref]
76. Eric A. Walker, Jonelle M. Petscavage-Thomas, Agustinus Suhardja, Mark D. Murphey. Metabolic Bone Lesions: Imaging
Pitfalls 713-741. [Crossref]
77. Megan B. Brickley, Annabelle Schattmann, Joelle Ingram. 2016. Possible scurvy in the prisoners of Old Quebec: A re-evaluation
of evidence in adult skeletal remains. International Journal of Paleopathology 15, 92-102. [Crossref]
78. Henry Knipe, Yuranga Weerakkody. Chronic venous insufficiency . [Crossref]
79. Michael V. Kushdilian, Lauren M. Ladd, Richard B. Gunderman. 2016. Radiology in the Study of Bone Physiology. Academic
Radiology 23:10, 1298-1308. [Crossref]
80. D.R. Shatzkes, L.E. Ginsberg, M. Wong, A.H. Aiken, B.F. Branstetter, M.A. Michel, N. Aygun. 2016. Imaging Appearance
of SMARCB1 (INI1)-Deficient Sinonasal Carcinoma: A Newly Described Sinonasal Malignancy. American Journal of
Neuroradiology 37:10, 1925-1929. [Crossref]
81. R. Newsome, M.J. Green, N.J. Bell, M.G.G. Chagunda, C.S. Mason, C.S. Rutland, C.J. Sturrock, H.R. Whay, J.N. Huxley.
2016. Linking bone development on the caudal aspect of the distal phalanx with lameness during life. Journal of Dairy Science
99:6, 4512-4525. [Crossref]
82. Mindy C. Pitre, Robert J. Stark, Maria Carmela Gatto. 2016. First probable case of scurvy in ancient Egypt at Nag el-Qarmila,
Aswan. International Journal of Paleopathology 13, 11-19. [Crossref]
83. Ramiro M Irastorza, Macarena Trujillo, Jose Martel Villagrán, Enrique Berjano. 2016. Computer modelling of RF ablation in
cortical osteoid osteoma: Assessment of the insulating effect of the reactive zone. International Journal of Hyperthermia 32:3,
221-230. [Crossref]
84. Mostafa El-Feky, Henry Knipe. Generalised periosteal reaction . [Crossref]
85. Andrew Dixon, Henry Knipe. Symmetrical periosteal reaction . [Crossref]
86. Sean Carlson, John Rauchenstein. 2015. Hypertrophic Osteoarthropathy. Journal of Osteopathic Medicine 115:12, 745-745.
[Crossref]
87. L. Martin-Francés, M. Martinon-Torres, A. Gracia-Téllez, J. M. Bermúdez de Castro. 2015. Evidence of Stress Fracture in a
Homo antecessor Metatarsal from Gran Dolina Site (Atapuerca, Spain). International Journal of Osteoarchaeology 25:4, 564-573.
[Crossref]
88. Yuqing Li, Wenjuan Wu, Zekun Zhang, Yang Ding, Mahrukh Latif. 2015. Sclerotic multiple myeloma with an unusual sunburst
periosteal reaction occurring in the sternum. Skeletal Radiology 44:5, 749-754. [Crossref]
89. Damien Bisseret, Rachid Kaci, Marie-Hélène Lafage-Proust, Marianne Alison, Caroline Parlier-Cuau, Jean-Denis Laredo,
Valérie Bousson. 2015. Periosteum: Characteristic imaging findings with emphasis on radiologic-pathologic comparisons.
Skeletal Radiology 44:3, 321-338. [Crossref]
90. Najme Anbiaee, Hamed Ebrahimnejad, Alireza Sanaei. 2015. Central odontogenic fibroma (simple type) in a four-year-old boy:
atypical cone-beam computed tomographic appearance with periosteal reaction. Imaging Science in Dentistry 45:2, 109. [Crossref]
91. P.A. Tyler, P. Mohaghegh, J. Foley, A. Isaac, A. Zavareh, C. Thorning, A. Kirwadi, I. Pressney, F. Amary, G. Rajeswaran.
2015. Tibial cortical lesions: A multimodality pictorial review. European Journal of Radiology 84:1, 123-141. [Crossref]
92. Ragna Redelstorff, Shoji Hayashi, Bruce M. Rothschild, Anusuya Chinsamy. 2015. Non-traumatic bone infection in stegosaurs
from Como Bluff, Wyoming. Lethaia 48:1, 47-55. [Crossref]
93. Meera Raghavan, Alex Hayes. 2014. Voriconazole-associated soft tissue ossification: an undescribed cause of glenohumeral joint
capsulitis. Skeletal Radiology . [Crossref]
94. O. Yapici Ugurlar, M. Ugurlar, A. Ozel, S. M. Erturk. 2014. Xiphoid syndrome: an uncommon occupational disorder.
Occupational Medicine 64:1, 64-66. [Crossref]
95. Alan J. Quigley, Samuel Stafrace. 2014. Skeletal survey normal variants, artefacts and commonly misinterpreted findings not to
be confused with non-accidental injury. Pediatric Radiology 44:1, 82-93. [Crossref]
96. Archana Malik, Jacqueline A. Urbine, Erica D. Poletto, Bret Kricun, Evan Geller, Polly Kochan, Robert L. Siegle, Eric N.
Faerber. Imaging 1-41. [Crossref]
97. Mark Thurston, Mohammad ElBeialy. Periosteal reaction from chronic venous insufficiency . [Crossref]
98. Ryoko Okahata, Hiroaki Shimamoto, Keisuke Marutani, Seiki Tomita, Atsutoshi Nakatani, Mitsunobu Kishino, Naoya
Kakimoto, Shumei Murakami, Souhei Furukawa. 2013. Diffuse large B cell lymphoma of the mandible with periosteal reaction:
A case report. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology . [Crossref]
99. A. Brinke, P.T.P.W. Burgers, M.M.M. Bruijninckx. 2013. Een man met een pijnlijke zwelling in het bovenbeen. Nederlands
Tijdschrift voor Traumatologie 21:3, 98-98. [Crossref]
100. Major Edward Sellon, Alex Liakos, David Sallomi, Hugh Anderson, Sam Panthakalam, David Howlett. 2013. Systemic disease
involvement of the hand: manifestations on plain radiograph. British Journal of Hospital Medicine 74:5, 275-281. [Crossref]
101. J. Aucourt, S. Aubert, A. Lesage, G. Lefebvre, A. Renaud, C. Maynou, A. Cotten. Tumeurs osseuses 461-520. [Crossref]
102. Eric M. Chen, Sulabha Masih, Kira Chow, George Matcuk, Dakshesh Patel. 2012. Periosteal Reaction. Contemporary Diagnostic
Radiology 35:17, 1-5. [Crossref]
103. Patrick Rock, Yuranga Weerakkody. Pachydermoperiostosis . [Crossref]
104. Afshin Mohammadi, Behrooz Ilkhanizadeh, Mohammad Ghasemi-rad. 2012. Mandibular plasmocytoma with sun-ray
periosteal reaction: A unique presentation. International Journal of Surgery Case Reports 3:7, 296-298. [Crossref]
105. Jim S. Wu, Mary G. Hochman. How to Evaluate a Bone Lesion 11-50. [Crossref]
106. Sandra Assis, Ana Luísa Santos, Charlotte A. Roberts. 2011. Evidence of hypertrophic osteoarthropathy in individuals from the
Coimbra Skeletal Identified Collection (Portugal). International Journal of Paleopathology 1:3-4, 155-163. [Crossref]
107. Juan Miguel Jimenez-Andrade, Joseph R. Ghilardi, Gabriela Castañeda-Corral, Michael A. Kuskowski, Patrick W. Mantyh.
2011. Preventive or late administration of anti-NGF therapy attenuates tumor-induced nerve sprouting, neuroma formation,
and cancer pain. Pain 152:11, 2564-2574. [Crossref]
108. Jung-Eun Cheon, In-One Kim, Woo Sun Kim, Kyung Mo Yeon. 2010. Isolated periostitis as a manifestation of systemic
vasculitis in a child: imaging features. Pediatric Radiology 40:S1, 116-119. [Crossref]
109. Thomas Kuchenbecker, A. Mark Davies, Steven L.J. James. 2010. (ii) The investigation and radiological features of primary
bone malignancy. Orthopaedics and Trauma 24:4, 252-265. [Crossref]
110. Marcello Henrique Nogueira-Barbosa, José Luiz de Sá, Clóvis Simão Trad, Rodrigo Cecílio Vieira de Oliveira, Jorge Elias
Júnior, Edgard Eduard Engel, Marcelo Novelino Simão, Valdair Francisco Muglia. 2010. Ressonância magnética na avaliação
das reações periosteais. Radiologia Brasileira 43:4, 266-271. [Crossref]
111. Matt Adams, Yuranga Weerakkody. Thyroid acropachy . [Crossref]

Periosteal Reaction: Residents

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Residents’ Section • Pat tern of the Month

inRadiology Periosteal Reaction

TABLE 1: Types of Periosteal Reaction TABLE 2: Differential Diagnosis of

Solid Psoriatic arthritis

Thick irregular Reactive arthritis

Aggressive Hypertrophic pulmonary osteoarthropathy

Laminated (onionskin) Thyroid acropathy

Sunburst Periosteal reaction of newborn

Codman triangle Stress fracture

AJR:193, October 2009 W259

W260 AJR:193, October 2009

Types of Periosteal Reaction

Fig. 3—Onionskin periosteal reaction (osteomyelitis).

AJR:193, October 2009 W261

Fig. 4—Hair-on-end periosteal reaction (Ewing’s

Fig. 5—Hair-on-end periosteal reaction (chronic

Differential Diagnosis of Periosteal Reaction

W262 AJR:193, October 2009

Physiologic Periosteal Reaction of the Newborn

AJR:193, October 2009 W263

W264 AJR:193, October 2009

AJR:193, October 2009 W265

Hypertrophic Pulmonary Osteoarthropathy

Fig. 12—Secondary hypertrophic osteoarthropathy.

W266 AJR:193, October 2009

Fig. 13—Hypertrophic pulmonary osteoarthropathy.

AJR:193, October 2009 W267

to confirm resolving hematoma.

W268 AJR:193, October 2009

Fig. 15—Osteogenic sarcoma. Lateral radiograph Fig. 16—Chondroblastoma. Radiograph shows

Leukemia and Lymphoma

AJR:193, October 2009 W269

Unilateral Versus Bilateral Periosteal Reaction

W270 AJR:193, October 2009

AJR:193, October 2009 W271

W272 AJR:193, October 2009

"REAVIZ" (REHABILITATION, DOCTOR AND HEALTH) . [Crossref]

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