“…[5] Isotope bone scanning is a highly sensitive means of assessing HOA; however, its findings are nonspecific and can occur with other forms of periosteal proliferation. [9,10] A bone scan was not performed in our patient, but the features of HOA were demonstrated with long bone roentgenographs. These features were bilateral, symmetrical, periosteal reactions with a laminar appearance in the femoral, tibial, ulnar and radial bones, with new periosteal bone formation in the proximal aspect of the right tibia.…”