Codman triangle explained

The Codman triangle (previously referred to as Codman's 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.[1] A Codman triangle is not actually a full triangle. Instead, it is often a 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. This two sided appearance is generated due to a tumor (or growth) that is growing at a rate which is faster than the periosteum can grow or expand, so instead of dimpling, the periosteum tears away and provides ossification on the second edge of the triangle.[2] The advancing tumour displaces the periosteum away from the bone medulla. The displaced and now lateral periosteum attempts to regenerate underlying bone. This describes a periosteal reaction.

The main causes for this sign are osteosarcoma, Ewing's sarcoma, eumycetoma, and a subperiosteal abscess.[3] [4]

Notes and References

  1. Web site: Codman's triangle - General Practice notebook . 2022-10-26 . gpnotebook.com . January 2018 . 2022-10-26 . https://web.archive.org/web/20221026085815/https://gpnotebook.com/simplepage.cfm?ID=-288358364 . live .
  2. Web site: Periosteal Reaction . 2022-10-26 . UW Radiology . en . 2022-10-26 . https://web.archive.org/web/20221026085813/https://rad.washington.edu/about-us/academic-sections/musculoskeletal-radiology/teaching-materials/online-musculoskeletal-radiology-book/periosteal-reaction/ . live .
  3. 8184073 . 10.1148/radiology.191.3.8184073 . 191 . Periosteal Ewing sarcoma . 1994 . Shapeero LG, Vanel D, Sundaram M, Ackerman LV, Wuisman P, Bauer TW, Neuenschwander S, Contesso G, Janney C, McDonald DJ. Radiology . 825–31.
  4. Hide . Geoff . April 19, 2018 . Imaging in Classic Osteosarcoma: Practice Essentials, Radiography, Computed Tomography . Medscape . October 26, 2022 . October 26, 2022 . https://web.archive.org/web/20221026085804/https://emedicine.medscape.com/article/393927-overview . live .

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