Zebra stripe sign (bones)

Last revised by Dr Mostafa El-Feky on 11 Nov 2020

The zebra stripe sign occurs where children with osteogenesis imperfecta have been treated with cyclical bisphosphonate therapy, e.g. pamidronate. When the drug is delivered in cycles, dense bone is formed while treatment is being given. This results in dense stripes across the metaphyses of bones which can be visualized radiographically. 

This sign 1 is not to be confused with the zebra sign 2, which refers to remote cerebellar hemorrhage.

Differential diagnosis

See also

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Figure 1: Hartmann's mountain zebra
    Drag here to reorder.
  • Case 1
    Drag here to reorder.
  • Case 2
    Drag here to reorder.
  • Case 3
    Drag here to reorder.
  • Case 4
    Drag here to reorder.
  • Case 5
    Drag here to reorder.
  • Case 6
    Drag here to reorder.
  • Case 7: on coronal T1WI
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.