Zebra stripe sign

Case contributed by Sepehr Haghighi
Diagnosis certain

Presentation

Recurrent patellar bone dislocation in osteogenesis imperfecta.

Patient Data

Age: 15 years
Gender: Female
mri

Numerous horizontal lines (zebra stripes) demonstrated at distal femur and proximal parts of tibia and fibula in a patient with history of osteogenesis imperfecta treated with bisphosphonate drugs. 

Case Discussion

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 metaphysis of bones which can be visualized radiographically as well as MRI.

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