PERIOSTEAL REACTION

infection:

osteomyelitis

cellulitis

congenital syphilis

neoplastic:

benign, eg. osteoid osteoma

malignant (1° bone tumours, eg. osteosarcoma, Ewing's sarcoma)

metastases [rarely cause periosteal reactions]

other:

trauma

polyarteritis nodosa

Langerhans cell histiocytosis

bilateral and symmetrical periosteal reaction:

hypertrophic osteoarthropathy

thyroid acropachy

vascular insufficiency

fluorosis [bones dense; ligamentous calcification common]

pachydermoperiosteitis [rare, familial, painless, self-limiting; adolescent male]

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