[citation needed] A periosteal reaction can result from a large number of causes, including injury and chronic irritation due to a medical condition such as hypertrophic osteopathy, bone healing in response to fracture, chronic stress injuries, subperiosteal hematomas, osteomyelitis, and cancer of the bone.

[citation needed] Other causes include Menkes disease and hypervitaminosis A.

Diagnosis can be helped by establishing if bone formation is localized to a specific point or generalized to a broad area.

The appearance of the adjacent bone will give clues as to which of these is the most likely cause.

[citation needed] Appearances include solid, laminated, spiculated, and the Codman triangle.