It can be seen with:
- osteosarcoma
- acute osteomyelitis
- Ewing sarcoma
- Langerhans cell histiocytosis (LCH)
Ewing sarcoma - distal femur - “Ewing sarcoma of the distal femur in a 9 year old boy with onion skin periosteal reaction.
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Onion skin periosteal reaction
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