Periosteal thickening

An imaging manifestation of chronic periosteal reaction characterized by formation of new bone layers or generalized thickening along the cortical surface, resulting in focal or diffuse cortical hyperostosis and increased outer bone diameter.

Causes

• Traumatic and mechanical causes

  • Fracture healing

  • Chronic repetitive stress or overuse injuries

  • Stress fractures

  • Mechanical irritation causing reactive periosteal bone formation

• Infectious and inflammatory causes

  • Osteomyelitis

  • Chronic bone infection

  • Soft tissue infection extending to the periosteum

  • Chronic inflammatory periostitis

• Bone malignancies causing periosteal reaction

  • Benign bone tumors: Osteochondroma, fibrous dysplasia

  • Ewing sarcoma

  • Osteosarcoma

  • Chondrosarcoma

• Inflammatory and rheumatologic causes

  • Reactive arthritis

  • Psoriatic arthritis

  • Other seronegative spondyloarthropathies

  • Chronic inflammatory arthropathies

• Endocrine and systemic causes

  • Graves’ disease

  • Hypertrophic pulmonary osteoarthropathy