Zebra sign - pamidronate therapy

Case contributed by Assoc Prof Frank Gaillard


History withheld.

Patient Data

Age: Child

X-rays of the knees and leg demonstrate prominent horizontal sclerotic lines affecting the metaphyses, relatively evenly spaced. The legs demonstrate gracile bones and bowing of the tibia

The distance between the lines at the distal end of the leg is less than that at the proximal end. This is a reflection of the greater growth occurring around the knee; as the doses of pamidronate are given regularly, more growth has occurred between doses at the knee than at the ankle. 

Case Discussion

Findings are in keeping with the so-called Zebra sign of pamidronate therapy for osteogenesis imperfecta (the diagnosis was established clinically). 

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Case information

rID: 8448
Published: 2nd Feb 2010
Last edited: 12th Sep 2019
Tag: knee
Inclusion in quiz mode: Included

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