Question 1115
{"accessible":true,"alternatives":[{"id":5572,"text":"Codman triangle"},{"id":5573,"text":"permeative appearance"},{"id":5574,"text":"soft-tissue mass"},{"id":5575,"text":"spiculated periosteal reaction"},{"id":5576,"text":"wide zone of transition"}],"archived":false,"correctAlternativeId":5575,"explanation":"\u003cp\u003eThe \u003ca href=\"/articles/periosteal-reaction\"\u003eperiosteal reaction\u003c/a\u003e in this case would best be described as \"interrupted multi-layered (onion skin)\" periosteal reaction with \u003ca href=\"/articles/codman-triangle-periosteal-reaction\"\u003eCodman triangle\u003c/a\u003e. It is not \u003ca href=\"/articles/spiculated-periosteal-reaction\"\u003espiculated periosteal\u003c/a\u003e reaction as this would be oriented perpendicular to the long axis of the bone with a sunburst or hair on end appearance. The bone lesion appears\u0026nbsp;permeative\u0026nbsp;with a wide zone of transition and is associated with a soft-tissue mass extending out of the bone, which is why the periosteal reaction is interrupted.\u003c/p\u003e","id":1115,"imageUrl":"https://prod-images-static.radiopaedia.org/images/5776850/b66d9a0c30cfb18a239f6f5c0f5d0f_big_gallery.jpg","imageAttribution":{"kind":"case","rID":27379},"imageAttributionCaseInfo":{"title":"Ewing sarcoma - humerus","contributor_name":"Jeremy Jones","contributor_param":"drjermy","case_rid":27379,"case_param":"ewing-sarcoma-humerus"},"firstQuestionPath":"/questions/2578","nextQuestionPath":"/articles/ewing-sarcoma/questions/1099","relatedArticles":[{"id":1860,"title":"Periosteal reaction","link":"/articles/periosteal-reaction?lang=us"},{"id":21097,"title":"Permeative process in bone","link":"/articles/permeative-process-in-bone?lang=us"},{"id":1142,"title":"Codman triangle periosteal reaction","link":"/articles/codman-triangle-periosteal-reaction?lang=us"},{"id":2067,"title":"Spiculated periosteal reaction","link":"/articles/spiculated-periosteal-reaction?lang=us"}],"alsoUsedIn":[{"id":1847,"kind":"Course","title":"Paediatric Lectures - page 1847","link":"https://radiopaedia.org/courses/paediatric-lectures/pages/1847"},{"id":233,"kind":"RestrictedPage","title":"Page 233 (in no courses)","link":"https://radiopaedia.org/admin/restricted_pages/233"},{"id":241,"kind":"Course","title":"Radiology Review Course - Melbourne - page 241","link":"https://radiopaedia.org/courses/radiology-review-course-melbourne-2019/pages/241"},{"id":241,"kind":"Course","title":"Radiology Review Course - Melbourne - page 241","link":"https://radiopaedia.org/courses/radiology-review-course-melbourne-2018/pages/241"},{"id":241,"kind":"Course","title":"Radiology Review Course - Melbourne - page 241","link":"https://radiopaedia.org/courses/radiology-review-course-melbourne-2020/pages/241"},{"id":241,"kind":"Course","title":"Radiology Review Course - page 241","link":"https://radiopaedia.org/courses/radiology-review-course-online/pages/241"},{"id":1094,"kind":"Course","title":"[TRIAL] X-ray Interpretation: Bone Lesions - page 1094","link":"https://radiopaedia.org/courses/trial-x-ray-interpretation-bone-lesions/pages/1094"},{"id":2061,"kind":"Course","title":"X-ray Interpretation: Bone Lesions - page 2061","link":"https://radiopaedia.org/courses/x-ray-interpretation-bone-lesions/pages/2061"},{"id":2061,"kind":"Course","title":"X-ray Interpretation: Bone Lesions Peer Review - page 2061","link":"https://radiopaedia.org/courses/x-ray-interpretation-bone-lesions-peer-review/pages/2061"}],"stem":"\u003cp\u003eHumeral radiograph of a 12-year-old male with Ewing sarcoma. Which\u0026nbsp;of the following aggressive features is \u003cstrong\u003eNOT\u003c/strong\u003e seen on this image?\u0026nbsp;\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1115"}],"attemptsPercentages":[{"alternativeId":"5572","percentage":13},{"alternativeId":"5575","percentage":59},{"alternativeId":"5573","percentage":7},{"alternativeId":"5576","percentage":5},{"alternativeId":"5574","percentage":16}],"promptToLogin":false,"questionManager":false,"articleId":"ewing-sarcoma"}