Causes of Bone sclerosis with a periosteal reaction

Causes of Bone sclerosis with a periosteal reaction

Most common

  • 1. Healing fracture .
  • 2. Metastasis —osteoblastic metastases from prostate.
  • 3. Osteoid osteoma/osteoblastoma —solid or lamellated periosteal reaction.
  • 4. Chronic osteomyelitis —look for sequestrum.
  • 5. Osteosarcoma —classically sunray spiculation.

Less common

  • 6. Ewing sarcoma —often onion-skin or lamellated periosteal reaction.
  • 7. Chondrosarcoma —chondroid matrix with regions of enchondral ossification.
  • 8. Lymphoma .
  • 9. CRMO —clavicles and tibias in children and adolescents.
  • 10. SAPHO syndrome —similar to CRMO but in adults. Although similar long bone changes may be seen, anterior chest wall and pelvic involvement predominate.
  • 11. Infantile cortical hyperostosis (Caffey’s disease) —infants <6 months of age. Multiple bones, especially mandible, ribs and clavicles.


  • 12. Melorheostosis —sclerotomal distribution. Cortical and medullary sclerosis likened to dripping candle wax.
  • 13. Tertiary syphilis —usually bilateral periostitis involving skull, clavicles, ribs and tibias. Mixed sclerotic and lytic ‘gummatous’ lesions can also be seen.

Sign up to receive the trending updates and tons of Health Tips

Join SeekhealthZ and never miss the latest health information