imaging in scurvy
TRANSCRIPT
JSS Medical College, Mysuru
Imaging in Scurvy
-Dr.ShilpaResident,
JSS Medical College ,Mysuru
Please visit www.jssmcradiology.com for more Radiology education
For more Radiology Education visit www.jssmcradiology.com
JSS Medical College, Mysuru
Introduction..
(Barlow’s disease, hypovitaminosis C)
• Pathology:• Vitamin C necessary for Endothelial lining : deficiency
causes increased vascular fragility• Decreased osteoblastic activity and cartilage proliferation
resulting in decreased formation of bony matrix• Normal mineralisation• Osteoporosis
JSS Medical College, Mysuru
Radiologic features1.Dense zone of provisional calcification (white line of
Frankel).
2.Corner (angle) sign-Corner (angle) sign.
Irregularity of the metaphyseal margins frequently
occurs secondary to infarctions of the epiphyseal-
metaphyseal junction.
3. Pelken’s spurs.
4. Scorbutic zone (Trümmerfeld’s zone).
5.Subperiosteal hemorrhage.
JSS Medical College, Mysuru
PA Knee:
Characteristic changes:
1. Generalized osteopenia,
2. Dense zone of provisional calcification,
3. Scorbutic zone,
4. Pelken’s spurs ,
5. Wimberger’s sign (ring epiphyses) and
6. Subperiosteal hemorrhages
JSS Medical College, Mysuru
WHITE LINE OF FRENKEL• White line in the zone of provisional
calcification at the growing metaphysis
• Dense zone of provisional calcification (white line of Frankel).
• Cartilage proliferation decreased with normal mineralisation resulting in widened and dense zone of provisional calcification
JSS Medical College, Mysuru
WIMBERGER SIGN• Epiphysis is small sharply
marginated by sclerotic rim with central portion more radiolucent.
• Due to decrease cartilage proliferation and unimpaired mineralization (sclerosis)
JSS Medical College, Mysuru
TRUMMERFELD ZONE (SCORBUTIC ZONE)
• Transverse radiolucent band adjacent to zone of provisonal calcification due to suppressed osteoblastic activity with normal mineralisation
• Trabecular bone mass is decreased in zone of primary and secondary spongiosa. Scorbutic zone (Trümmerfeld’s zone).
JSS Medical College, Mysuru
PELKAN’S SPUR
• Zone of provisional calcification extends
beyond the margins of the metaphysis
resulting in periosteal elevation and marginal
spur formation
• These bony protuberances occur at the
metaphyseal margins and extend at right
angles away from the shaft axis.
JSS Medical College, Mysuru
CORNER (ANGLE) SIGN
• Irregularity of the metaphyseal margins secondary to infractions of the epiphyseal-metaphyseal junction
JSS Medical College, Mysuru
SUBPERIOSTEAL HEMORRAGES
• Due to increased capillary permeability
• Seen in ends of long bones(femur,tibia, humerus)
• May cause periosteal elevation and new bone formation
JSS Medical College, Mysuru
Thank You
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