The differential diagnosis of dense metaphyseal bands is wide.
Differential diagnosis
Common
- chronic anemia, e.g. sickle cell disease, thalassemia
- chemotherapy, e.g. methotrexate
- growth acceleration lines following growth arrest due to systemic illness or stress in infancy or childhood, e.g. asthma, diabetes, cystic fibrosis, juvenile chronic arthritis, juvenile rheumatoid arthritis, malnutrition
- lead poisoning
- leukemia: treated
- normal variant: especially in a neonate - dense zone of provisional calcification
- renal osteodystrophy (secondary hyperparathyroidism): healing
- rickets: healing
- trauma: non-accidental injury; stress fracture
Uncommon
- aminopterin fetopathy
- bisphosphonate therapy
- chronic recurrent multifocal osteomyelitis
- congenital transplacental infection, e.g. toxoplasmosis, rubella, cytomegalovirus, herpes, syphilis
- deprivation (psychosocial) dwarfism with trauma
- drug or hormone therapy in high dosage, e.g. steroids, parathyroid hormone, methotrexate, estrogen or heavy metal therapy to the mother during pregnancy
- dysosteosclerosis
- other heavy metal or chemical poisoning, e.g. bismuth, arsenic, phosphorus, fluoride, mercury, lithium, radium, Thorotrast
- hypervitaminosis D
- hypoparathyroidism/pseudohypoparathyroidism
- hypothyroidism: cretinism (treated)
- meconium peritonitis (neonatal dense bands)
- metaphyseal chondrodysplasia(s)
- osteopetrosis
- oxalosis
- parathyroid hormone therapy
- Patterson syndrome
- radiation injury from bone-seeking isotopes (strontium-90, yttrium-90, phosphorus-32)
- sclerosteosis: especially knees
- scurvy: healing
- spondyloepimetaphyseal dysplasia(s)
- spondylometaphyseal dysplasia(s)
- vascular injury
- Williams syndrome: idiopathic hypercalcemia
Unable to process the form. Check for errors and try again.