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Periosteal reaction refers to mineralization of periosteum overlying the cortex.  Please note  that this program does not recognize the  expanded  cortex overlying an   extraosseous tumor as a periosteal   reaction.  Among the three choices offered for periosteal reaction select "Minimal Or No Periosteal Reaction" if no significant extracortical mineralization is present. Select "Periosteal Reaction In The Form Of Codman Triangle"  if the cortex is destroyed  and the  periosteum  has been interrupted  by the tumor process.