Image Question-39

What is the marked structure in the Image?

A. Bone graft implantation

B. Fracture Tibia

C. Codman Triangle

D. Soap bubble appearance

Codman triangle

Codman triangle – is the triangular area of new subperiosteal bone that is created when a lesion, often a tumour, raises the periosteum away from the bone

Causes for Codman triangle sign

  1. Osteosarcoma
  2. Ewing’s sarcoma
  3. Eumycetoma
  4. Subperiosteal abscess


Codman triangle – Pseudotriangle on radiographic findings, with ossification on the original bone and one additional side of the triangle, which forms a two sided triangle with one open side

Periosteal reaction

Periosteal reaction that occurs when bone lesions grow so aggressively that they lift the periosteum off the bone and do not allow the periosteum to lay down new bone.

It is a pattern of interrupted periosteal reaction where the periosteum gets lifted at either end of the aggressive lesion, and the central aspect of the lesion does not have any overlying ossification.

This state gives the appearance on plain films of a raised triangle of periosteum along the edges of the lesion.

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