SCURVY (cont.)
• Epiphyseal separation or fragmentation in the region of metaphysis
• Dense , linear calcification at metaphyseal end “ White line of Frankel”
• Bony spur “ Pelkan spur “
• Transverse radiolucent band “ Scurvy line “
• Subperiosteal hematoma
Osteoporosis
Thinning of cortex
Thin , dense ring-like epiphysis = Wimberger’s ring
Dense linear calcification at distal metaphysis = White line of Frankel
Bony spur = Pelkan spur
Transverse radiolucent zone = Truemmerfeld zone
Subperiosteal hematoma
Osteoporosis
Thinning of cortex
Thin , dense ring-like epiphysis = Wimberger’s ring
Dense linear calcification at distal metaphysis = White line of Frankel
Bony spur = Pelkan spur
Transverse radiolucent zone = Truemmerfeld zone
Subperiosteal hematoma
Neurological Disease in
Children
NORMAL SKULL FILM
CRANIOFACIAL RATIO :
Newborn : 4 - 4.5 : 1
2 years : 3 - 3.5 : 1
6 years : 2.5 : 1
Adult : 1.5 - 2 : 1
SUTURE : Newborn ~ 1cm
3 years ~ 2 mm
Moulding = Parietooccipital overlapping : upto 2 weeks
Sutures close ~ 14 years old
NORMAL SKULL FILM cont.
FONTANELLE :
• Anterior F. close ~ 1.5 years ( 15 - 18 months )
• Posterior F close ~ 0.5 year ( 2 - 6 months )
CONVOLUTIONAL MARKINGS :
• Visible at 2 years
• Maximal apparence at 4 years
• Disappear by 8 years
6 days old
F , 10 months oldF , 10 months old
M , 5 years 7 monthsM , 5 years 7 months
NORMAL SKULL FILM
WORMIAN BONES :
• Island of bones within A & P fontanelle,
Lambdoid and posterior sagittal sutures
• Abnormal in : Cliedocranial disostosis ,
cretinism , etc.
WIDE SUTURES : DDx
• Increased intracranial pressure :
Obstruction of ventricular system = hydrocephalus
Space occupying lesion +/- hydrocephalus : mass, cyst
Brain edema
• Infiltration in sutures
Neuroblastoma
Leukemia
Lymphoma
SIGN OF INCREASED INTRACRANIAL PRESSURE
• Increased head size and craniofacial ratio
• Separation of sutures before 10 years ( esp. in 1 - 5 yrs old )
• Increased convolutional markings
• Pressure change of sella tursica
Anterior wall of dursum sella and posterior clinoid
process
Floor of sellar tursica and posterior wall of dorsum
sella
Enlarged sella tursica and change in shape