Ans. C) Thick and irregular

Option C)

The inner cambium layer of periosteum responds to localized insult or injury by forming a new layer of bone along the surface of the underlying cortex; this new bone formation is called periosteal reaction.
Such periosteal reaction can be divided into aggressive and non-aggressive reaction or no reaction at all.
Non-aggressive reactions are thin, solid, thick and irregular.
Aggressive reactions are spiculated, laminated, hair-on-end, sun burst, disorganised, interrupted and Codman’s triangle.

Explanation:

Option A. Spiculated. Spiculated periosteal reactions are aggressive reactions, commonly seen in malignant lesions like osteosarcoma as sunray appearance.

Option B. Laminated. Lamellated are aggressive reactions that are seen in malignant or chronic lesions like chronic osteomyelitis, ewing’s sarcoma as onion peel appearance.

Option D. Interrupted. Interrupted type of periosteal reaction is seen when the periosteum cannot produce new bone as fast as the growth of the lesion.

Educational objective:

Please note: These categories are not synonymous with benign and malignant, as there are benign entities capable of inducing aggressive periosteal reaction (e.g., infection and Langerhans cell histiocytosis) and numerous malignant entities that more commonly manifest with either non aggressive periosteal.

Bone & Imaging

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