Periosteal reaction is not common in -

Periosteal reaction Besides covering the bone and sharing some of its blood supply with the bone, periosteum (particularly cambium layer) also produces bone when it is stimulated. Practically anything that breaks, tears, stretches, inflames or even touches the periosteum, stimulates the reactive bone formation by periosteum. This is called periosteal reaction. Important causes of periosteal reaction are:- Infection:- Osteomyelitis, Brodie's abscess, syphilis Neoplasms Benign: Osteoid osteoma Malignant: Ewing's sarcoma, osteosarcoma Eosinophilic granuloma Healed stress fracture Hypertrophic pulmonary osteoarthropathy Option d requires specific mention here Radiographically, the tubercular lesion of long bones is lytic with no or minimal periosteal reaction. Tuberculosis of short tubular bones of the hands and feet (tubercular dactylitis) has a different appearance, the so-called spina ventosa, consisting of bony expansion and prominent periosteal reaction.