Imaging in Scurvy

-Dr.Shilpa
Resident,
JSS Medical College ,Mysuru

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For more Radiology Education

visit www.jssmcradiology.com JSS Medical College, Mysuru
 Introduction..

(Barlow’s disease, hypovitaminosis C)

• Pathology:
• Vitamin C necessary for Endothelial lining :
deficiency causes increased vascular fragility
• Decreased osteoblastic activity and cartilage
proliferation resulting in decreased formation of
bony matrix
• Normal mineralisation
• Osteoporosis

JSS Medical College, Mysuru

 Radiologic features
1.Dense zone of provisional calcification (white line of
Frankel).

2.Corner (angle) sign-Corner (angle) sign.

Irregularity of the metaphyseal margins frequently

occurs secondary to infarctions of the epiphyseal-
metaphyseal junction.

3. Pelken’s spurs.

4. Scorbutic zone (Trümmerfeld’s zone).

5.Subperiosteal hemorrhage.
JSS Medical College, Mysuru
PA Knee:
Characteristic changes:

1. Generalized osteopenia,
2. Dense zone of provisional calcification,
3. Scorbutic zone,
4. Pelken’s spurs ,
5. Wimberger’s sign (ring epiphyses) and
6. Subperiosteal hemorrhages

JSS Medical College, Mysuru

WHITE LINE OF FRENKEL
• White line in the zone of provisional
calcification at the growing metaphysis

• Dense zone of provisional calcification

(white line of Frankel).

• Cartilage proliferation decreased with

normal mineralisation resulting in
widened and dense zone of provisional
calcification

JSS Medical College, Mysuru

WIMBERGER SIGN
• Epiphysis is small sharply
marginated by sclerotic rim
with central portion more
radiolucent.

• Due to decrease cartilage

proliferation and unimpaired
mineralization (sclerosis)

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TRUMMERFELD ZONE (SCORBUTIC ZONE)

• Transverse radiolucent band adjacent

to zone of provisonal calcification due
to suppressed osteoblastic activity
with normal mineralisation

• Trabecular bone mass is decreased in

zone of primary and secondary
spongiosa. Scorbutic zone
(Trümmerfeld’s zone).

JSS Medical College, Mysuru

PELKAN’S SPUR

• Zone of provisional calcification extends

beyond the margins of the metaphysis
resulting in periosteal elevation and marginal
spur formation

• These bony protuberances occur at the

metaphyseal margins and extend at right
angles away from the shaft axis.

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CORNER (ANGLE) SIGN

• Irregularity of the metaphyseal

margins secondary to infractions
of the epiphyseal-metaphyseal
junction

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SUBPERIOSTEAL HEMORRAGES

• Due to increased capillary

permeability

• Seen in ends of long

bones(femur,tibia, humerus)

• May cause periosteal elevation and

new bone formation

JSS Medical College, Mysuru

 Thank You

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JSS Medical College, Mysuru