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It is called onion skin periosteal reaction because it resembles the layers of an onion. These layers are formed due to any pathological process that leads to the variable, excessive growth of the bone. [1] Onion skin periosteal reaction is seen in osteosarcoma, [2] Ewing sarcoma and Langerhans cell histiocytosis. [3]
Examples of periosteal reactive bone in selected specimens of Triceratops. A periosteal reaction can result from a large number of causes, including injury and chronic irritation due to a medical condition such as hypertrophic osteopathy, bone healing in response to fracture, chronic stress injuries, subperiosteal hematomas, osteomyelitis, and cancer of the bone.
Onion skin periosteal reaction; Osteopathia striata; Osteoporosis circumscripta; P. Pad sign; Palla's sign; ... Sunburst periosteal reaction; Superior triangle sign;
The proliferative reaction of bone can also create delicate laminations constituting the periosteal layers and giving the radiographic appearance of an onion peel. [10] Plain films add valuable information in the initial evaluation or screening.
The advancing tumour displaces the periosteum away from the bone medulla. The displaced and now lateral periosteum attempts to regenerate underlying bone. This describes a periosteal reaction. [citation needed] The main causes for this sign are osteosarcoma, Ewing's sarcoma, eumycetoma, and a subperiosteal abscess. [3] [4]
Acute periostitis is due to infection, characterized by diffuse formation of pus, severe pain, and constitutional symptoms, and usually results in necrosis.It can be caused by excessive physical activity as well, as in the case of medial tibial stress syndrome (also referred to as tibial periostalgia, soleus periostalgia, or shin splints).
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The periosteal cells distal to (at the far end of) the fracture gap develop into osteoblasts, which form woven bone [citation needed] through bone resorption of calcified cartilage and recruitment of bone cells and osteoclasts. [4] The fibroblasts within the granulation tissue develop into chondroblasts which also form hyaline cartilage.