Pediatric Physiologic Periosteal Reaction

  • Etiology:
  • Imaging Radiograph:
    — Location – tibia more common than femur which is more common than humerus which is more common than other long bones
    — Only diaphyseal in location and any metaphyseal periosteal reaction is abnormal
  • DDX:
  • Complications:
  • Treatment:
  • Clinical: Typically seen in ages 1 to 4 months

Radiology Cases of Physiologic Periosteal Reaction

Radiograph of physiologic periosteal reaction
AP radiograph of the lower extremities shows faint symmetrical periosteal reaction in the diaphyseal region of the tibas bilaterally.
US of Tamm Horsfall proteins
Sagittal US of the right kidney (above) and left kidney (below) show multiple round echogenic foci in the renal pyramids bilaterally.