Sunburst periosteal reaction in osteogenic sarcoma

Excerpt

A 16-year-old boy presented with a recent onset of pain in the right arm. Radiographs of the right shoulder demonstrated an ill-defined, permeative, destructive lesion of the proximal humerus (Fig. 1), with prominent spiculated or sunburst periosteal reaction consistent with a primary osteogenic sarcoma. MRI was also performed to characterize the lesion further and determine the extent of the disease. Axial and coronal fat-saturated T2-weighted FSE images demonstrated florid, circumferential sunburst periosteal reaction, with tumor extending into the joint capsule and bicipital groove (Figs. 2, 3). Tumor and reactive bone-marrow edema extended into the distal humeral shaft, and there was a large associated soft-tissue mass.

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