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©2013 UpToDate ® Print Email Aneurysmal bone cyst periosteal reaction Distal ulna. Note the large, expansile aneurysmal bone cyst affecting the distal portion of the ulna. Periosteal new bone formation near the peripheral margins of the lesion creates a buttressing effect, which is characteristic of aneurysmal bone cyst (arrows). Reproduced with permission from: Yochum TR, Rowe LJ. Yochum and Rowe's Essentials of Skeletal Radiology, Third Edition. Philadelphia: Lippincott Williams & Wilkins, 2004. Copyright © 2004 Lippincott Williams & Wilkins.