Complete imaging features of Scurvy is covered in the topic

1. JSS Medical College, Mysuru
Imaging in Scurvy
-Dr.Shilpa
Resident,
JSS Medical College ,Mysuru
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2. 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

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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.

4. 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

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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

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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).

8. 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.

9. JSS Medical College, Mysuru
CORNER (ANGLE) SIGN
• Irregularity of the metaphyseal
margins secondary to infractions
of the epiphyseal-metaphyseal
junction

10. JSS Medical College, Mysuru
SUBPERIOSTEAL HEMORRAGES
• Due to increased capillary
permeability
• Seen in ends of long
bones(femur,tibia, humerus)
• May cause periosteal elevation and
new bone formation

11. JSS Medical College, Mysuru
Thank You
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