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Multilayered periosteal reaction

Multilayered periosteal reaction, also known as a lamellated or onion skin periosteal reaction, demonstrates multiple concentric parallel layers of new bone adjacent to the cortex, reminiscent of the layers on an onion. The layers are thought to be the result of periods of variable growth 2 and indicate a pathological process of intermediate aggressiveness.


It has been associated with:

See also

Inspired signs

Article information

rID: 1697
Section: Gamuts
Tag: refs, refs
Synonyms or Alternate Spellings:
  • Onion skin periosteal reaction
  • Lamellated periosteal reaction

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Cases and figures

  • Figure 1: photograph - onion
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  • Case 1: Ewing sarcoma with onion skin
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  • Figure 2: types of periosteal reactions
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  • Case 2: Langerhan's cell histiocystosis
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  • Case 3: Langerhans cell histiocytosis
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  • Case 4: prostate cancer metastasis
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  • Case 5: Ewing sarcoma of the fibula
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  • Case 6: Ewing sarcoma - Iliac bone
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