Zebra stripe sign (bones)

Last revised by Rohit Sharma on 27 Jan 2023

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

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