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.
It has been associated with:
- acute osteomyelitis
- Ewing sarcoma
- Langerhans cell histiocytosis (LCH)
- hypertrophic osteoarthropathy