Case contribution: Dr Radhiana Hassan
Clinical:
- A 13 years old girl
- Underlying ostegenesis imperfecta on biphosphonate treatment
- Multiple admission due to injury after trivial trauma
- Mainly involving the limbs
X-Ray findings:
- There are alternating lucent and sclerotic lines at metaphyseal region of femur and tibia (white arrows) giving rise to zebra stripe sign
- Bowing of the long bones are also seen
- Osteoporosis evidence by coarse trabeculation and cortical thinning
- Multiple and multiages fracture (images not shown)
Diagnosis: Osteogenesis imperfecta
Discussion: Zebra stripe sign
- Alternating radiolucent and radiodense metaphyseal lines can occur in a few conditions such as growth arrest, rickets on prolong treatment, osteopetrosis, chemotherapu, biphosphonate therapy, chronic anemia and treated leukaemia
- Zebra stripe sign occurs in children with osteogenesis imperfecta treated with cyclical biphosphonate therapy
- This is due to bone formation white treatment is given resulting in dense stripes across the metaphysis and can be visualized radiographically.
