Which radiographic feature set is associated with osteosarcoma as potential findings?

• A. Sunray appearance
• B. All of the above
• C. Codman triangle
• D. Periosteal reaction

Answer: (B)

Osteosarcoma often shows an aggressive periosteal response with recognizable radiographic patterns. A sunray (sunburst) appearance arises from perpendicular radiating bone spicules formed by rapid periosteal new bone. Codman triangle refers to a triangular area of raised periosteum at the advancing edge of the lesion. Periosteal reaction, in general, describes any new bone formation along the cortex due to an aggressive process. In osteosarcoma these features can occur together or separately, and when you see multiple of these classic signs, it strengthens the recognition of this tumor. That’s why the option including all of these findings is the best answer.