Causes of New Periosteal Bone Formation

  1. Infection
  2. Trauma
  3. Tumour include, leukaemia, neuroblastoma etc
  4. Caffey’s disease
  5. Scurvy
  6. Hypervitaminosis A
Causes of New Periosteal Bone Formation, radiograph showing a codman triangle of periosteal new bone
Radiograph showing a Codman triangle of periosteal new bone. Image by User:Ajimsha619, Wikimedia Commons, CC BY-SA 3.0.

Caffey Disease

  • Infantile cortical hyperostosis
  • Characteristics
    • Febrile
    • Hyperirritability
    • Swelling of the soft tissue
    • Cortical thickening of bone
  • Bones of jaw, forearm most affected
  • Average onset is 9 weeks
  • Rule out infection
  • Usually expectant management

Hypervitaminosis A

  • Xs leads to lysosomal rupture

Scurvy

  • Deficiency of vit C
  • Hydroxylation of proline & lysine requires Vit C as a cofactor
  • Get abnormal physis & haemorrhage below the periosteum

Tumoral Calcinosis

  • Error of phosphate metabolism
  • In skeletally mature patient – phosphate restriction, consider work up of hypervitaminosis D, hyperparathyroidism, collagen vascular disease
  • Excision not always curative

Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.