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Zebra lines

Case contributed by: Dr Jeremy Jones

Presentation:

History of cyclical bisphosphonate therapy

Modality: X-ray

The bones of the ankle and foot are abnormal with increased sclerosis. Features are of osteopetrosis. In addition, there are multiple transverse sclerotic lines (zebra lines) projected across the distal metaphysis that are the result of cyclical bisphosphonate therapy.

Case Discussion:

This young patient's distal tibia and fibula demonstrate multiple horizontal sclerotic bands, consistent with the so-called zebra stripe sign as a result of cyclical bisphosphonate therapy.

There is background osteopetrosis.

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