Q: What is the radiological picture in scurvy following treatment?

A: With onset of healing, the cortex becomes thicker & spongiosa is more clearly defined. The transverse band of diminished density in metaphysis regains its normal density & disappears as terminal spongiosa & cortex become completely mineralized. As growth proceeds, the thickened provisional zone of calcification is buried within the shaft as a "Transverse line". When a subperiosteal hematoma is present, raised periosteum begins to layer the periphery of hematoma with a new shell of subperiosteal bone. Concurrent with resorption of hematoma, this new layer of bone thickens & shrinks down onto the shaft to become the new cortex. Residue of this cortical thickening may persist for years. Central inset of rarefaction may also persist for years in epiphyseal centres.

Q: If Rickets & Scurvy both co-exist what changes would be seen on X-ray & why?

A: Multiple deficiencies may modify Roentgen appearance of skeletal response. Difference in time of onset of individual deficiencies as well as periods of remission & relapse may also affect classical description.When scurvy & Rickets both are present, scurvy features predominate because of diminished osteoblastic activity. The consequent low alkaline phosphatase levels contrast with high levels in rickets that are associated with excessive osteoid production.

Q: Is there any other Wimberger's sign in radiology?

A: In congenital syphilis, there are erosions involving upper medial surfaces of tibia. This is also known as Wimberger's sign.

Q: What is scurvy line?

A: Lucent transverse band between sclerotic provisional zone & heavier spongiosa deeper in shaft is called as scurvy line.

Last updated on 13-01-2001