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Zebra lines

Case contributed by Jeremy Jones
Diagnosis certain

Presentation

History of cyclical bisphosphonate therapy

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, the zebra stripe sign, as a result of cyclical bisphosphonate therapy.

There is background osteopetrosis.

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