dense metaphyseal bands

Price excludes VAT (USA) Plumbism reinvented: childhood lead poisoning in France, 1985-1990. 626:96-98. American Association for the Advancement of Science, American Institute of Ultrasound in Medicine, Royal College of Physicians and Surgeons of the United States, British Society of Interventional Radiology, Society of Nuclear Medicine and Molecular Imaging, American Association for Women Radiologists. 101(6):E7. [1, 2, 3, 4, 5], Plain skeletal radiographs have been used extensively in the diagnosis of lead poisoning in children. Wolfgang Dhnert. Do not surround your terms in double-quotes ("") in this field. The Hand in Radiologic Diagnosis, With Gamuts and Pattern Profiles. Become a Gold Supporter and see no third-party ads. Tutar HE, Atalay S, Uysalel A, et al. A radiograph of the knee showing dense metaphyseal bands strongly supports the diagnosis of lead poisoning. 2003 Jan. 33(1):11-4. Imaging: dense metaphyseal bands, suture separation due to lead encephalopathy (brain edema), dense ingested lead containing objects in GI tract Clinical: abdominal distension + pica Radiology Cases of Lead Poisoning Ian Turnbull, MBChB, DMRD, FRCR Former Lecturer, Department of Radiology, University of Manchester Medical School; Former Consulting Neuroradiologist, Hope Hospital, Salford, Manchester and North Manchester General Hospital, UKDisclosure: Nothing to disclose. A clinical diagnosis of transient synovitis was made. [19], CT plays a minor role in the diagnosis of lead poisoning. A 40-year-old man with end-stage kidney disease and calcium oxalate nephrolithiasis presented to the emergency department with joint pain. [12] The patient presented with hypotonia, developmental delay, and complex seizures. Marta Hernanz-Schulman, MD, FAAP, FACR Professor, Radiology and Radiological Sciences, Professor of Pediatrics, Department of Radiology, Vice-Chair in Pediatrics, Medical Director, Diagnostic Imaging, Vanderbilt Children's Hospital Tax calculation will be finalised during checkout. J Trop Pediatr. Among young adults, bone lead levels greater than the degree of measurement uncertainty were confined entirely toindividuals who had grown up in housing that was estimated to have been built before 1955. Hollerman et al describe the substantial contribution radiologists can make to the evaluation and treatment of the patient with a gunshot wound. Reference article, Radiopaedia.org (Accessed on 02 May 2023) https://doi.org/10.53347/rID-12433, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":12433,"questionManager":null,"mcqUrl":"https://radiopaedia.org/articles/hypovitaminosis-c-scurvy-1/questions/45?lang=us"}, View Mostafa El-Feky's current disclosures, see full revision history and disclosures, antineutrophil cytoplasmic antibodies (ANCA), 1. 1986 Feb. 146(2):267-70. 8 (2): 55-64. Opaque metaphyseal bands in the upper and lower tibia and the upper fibula secondary to lead poisoning in a child. Search In patients with chronic lead poisoning, opaque transverse metaphyseal bands appear in growing tubular bones. Trope I, Lopez-Villegas D, Cecil KM, Lenkinski RE. J Toxicol Clin Toxicol. Bullets, ballistics, and mechanisms of injury. Mutat Res. Fortschr Rontgenstr. Part of Springer Nature. no financial relationships to ineligible companies to disclose. Check for errors and try again. 1990 Oct. 155 (4):691-702. [23]. Such a childhood environment fosters exposure to biologically absorbable lead through the ingestion of dust contaminated with lead paint and water contaminated from lead pipe. Goldfrank's Toxicologic Emergencies, Tenth Edition. Balani A, Golla N, Dey AK, Mahankali S, Seelam S. Image of the month: Intracranial calcifications due to chronic lead exposure. "The Dense Metaphyseal Band Sign1.". Now presented with severe knee pain. 1990 Oct. 155 (4):685-90. sickle cell disease , thalassemia chemotherapy, e.g. 7. Also, see eMedicineHealth's patient education article Poisoning. Chelation therapy led to an increase in urine lead excretion without symptomatic improvement. Radiology. Both underwent a comprehensive neuropsychological evaluation. The child was advised to practice sports. 50(4):337-40. This is a preview of subscription content, access via your institution. [QxMD MEDLINE Link]. 1999 Apr. This is the origin of the word plumber and plumbing as lead has been widely used for water pipes in the home since Roman times, and also 'plumbism', a synonym for lead poisoning 5. physiological appearances in <3 years' age group, ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Functional MRI now offers the means to noninvasively study this plastic reorganization of the brain in children and adults. 48:1-38. Reference article, Radiopaedia.org (Accessed on 02 May 2023) https://doi.org/10.53347/rID-8549. With chronic exposure to lead, patchy calcifications may be seen on MRI scans (though these are better seen on CT scans). APPEARANCE Dense metaphyseal bands, less commonly known as dense metaphyseal lines, transverse bands, or "lead lines," indicate radiopaque bone (thicker than the adjacent diaphyseal cortex) at the metaphysis of growing bone, particularly at the wrists and knees ( Figs 1 , 2 ). Woolf AD, Goldman R, Bellinger DC. Johnston MV, Nishimura A, Harum K, et al. {"url":"/signup-modal-props.json?lang=us"}, Salam H, Deng F, Bell D, et al. Radiology Review Manual. 2016 Oct. 16 (5):494. Defective bone absorption can "wax and wane," leading to alternating dense and lucent metaphyseal bands and a bone-in-bone appearance. Single transverse lines predominate, but multiple bands may be seen in cases of episodic lead poisoning. These metaphyseal bands, or lead lines, usually do not occur until blood lead levels (BLLs) reach 70-80 mcg/dL; they are not an early manifestation of lead intoxication. They appear on radiographs as bone that is more radiopaque that the adjacent diaphyseal cortex. Lead resists corrosion; in fact, lead pipes bearing the insignia of Roman emperors that were used as drains from the baths are still in service. The differential diagnosis for lucent transverse metaphyseal lines or bands may be recalled using various mnemonics: CAMEL LINING Mnemonics CAMEL C: congenital infection (e.g. Unable to process the form. {"url":"/signup-modal-props.json?lang=us"}, Radswiki T, El-Feky M, Fahrenhorst-Jones T, et al. Albers and Bromberg reported a case of X-linked bulbospinomuscular atrophy, or Kennedy disease, masquerading as lead neuropathy. Muscle Nerve. Ingestion is more common in children, while the inhalation route is more frequent in occupationally exposed adults. Bone changes in hematologic disease. Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR Consultant Radiologist and Honorary Professor, North Manchester General Hospital Pennine Acute NHS Trust, UK Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. The other patient, the last patient of the series, was a 2.5-year-old ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Unlike most other animals, humans cannot produce their own vitamin C. Lack of dietary vitamin C (ascorbic acid) may be related to inadequate food intake, the destruction of vitamin C in food caused by cooking and canning, or the absence of fresh fruit in the diet. Table 1. Causes of lead poisoning include pica, industrial exposure, drinking moonshine liquor, gunshot wounds, retained lead pellets or particles, and a variety of folk remedies and cosmetics. Radiology Lead is a bluish-white metal of bright luster. [14] Plain skeletal radiography revealed opaque metaphyseal bands in all 15 infants; these were best seen around the knee joint. Vitamin C is essential for collagen synthesis, acting as a coenzyme to producing cross-linking of collagen fibers. drug or hormone therapy in high dosage,e.g. Epub 2020 Mar 18. skybjugr (Old Norse): a swelling (bjugr) from drinking sour milk (skyr) on long sea voyages. 139(1):81-5. They appear on radiographs as bone that is more radiopaque that the adjacent diaphyseal cortex. 54(2):271-94, viii. [6]. Hollerman JJ. Flora SJ. Zou HJ, Ding Y, Huang KL, et al. may show bands of increased density at the metaphyses can affect any metaphysis, but the involvement of the proximal fibula and distal ulnar metaphyses is highly suggestive may show bone-in-bone appearance abdominal radiographs utile for identification of exposure source and anatomic location if an ingestion is suspected 7 Robbins and Cotran Pathologic Basis of Disease. Plain abdominal radiograph in a 3-year-old patient shows multiple metallic particles due to ingested flakes of lead paint. In healthy infants 3 years of age or younger, the finding of increased metaphyseal opacity is not unusual. This patient was encephalopathic and anemic and had a lead level of 60 g/dL (2.898 mol/L) at admission. Lead has been used extensively since ~7000 BCE 5. 2002 Jan. 23(1):25-41. Dense transverse metaphyseal lines (mnemonic). View larger version: In this window In a new window Download as PowerPoint Slide Figure 1. Reference article, Radiopaedia.org (Accessed on 02 May 2023) https://doi.org/10.53347/rID-21388. Arch Pediatr Adolesc Med. 8. [QxMD MEDLINE Link]. Blickman JG, Wilkinson RH, Graef JW. Biomed Environ Sci. Dense metaphyseal bands at the growth plates in long bones, epiphyseal ossification centers, anterior rib ends, sternum and spine were observed. This process is thought to be the basis for the plasticity of the developing brain or its capacity to adapt in behavior and circuitry in response to stimulation from the external environment. Thanks for helping us catch any problems with articles on DeepDyve. Ralph Weissleder, Jack Wittenberg, Mukesh G. Harisinghani. No other abnormality was depicted on CT. At admission, the patients were found to have increased serum lead levels (54-72 mcg/dL; normal range, 0-30 mcg/dL). Dense metaphyseal bands Case contributed by Dr Imran Ahmad Khan Diagnosis certain Share Add to Citation, DOI & case data Presentation Severe knee pain. 2001. The Effect of Lead on the Red Cell Membrane. Omare M, Kibet J, Cherutoi J, Kengara F. A Review of Tobacco Abuse and Its Epidemiological Consequences. 56:1-16. Clinical manifestations vary, ranging from mild (or asymptomatic) cases to a severe life-threatening encephalopathy 6. Mennel EA, John SD. 2023 DeepDyve, Inc. All rights reserved. 2008, Seen in up to 50% of patients with acute lymphoblastic leukemia, Believed to represent a disturbance of enchondral ossification, Most often seen in distal femur, proximal tibia (around knee), proximal humerus, distal radius, ulna, Lucent transverse band in the metaphysis of rapidly growing bones, Generally appear of uniform thickness across metaphysis, Congenital infections such as toxoplasmosis, rubella, cytomegalovirus, herpes and syphilis (TORCH infections), Any prior, severe, usually childhood illness. A workup was notable for nephrocalcinosis on imaging;. [QxMD MEDLINE Link]. ADVERTISEMENT: Supporters see fewer/no ads. Search and discover articles on DeepDyve, PubMed, and Google Scholar, Organize articles with folders and bookmarks, Collaborate on and share articles and folders. Thalassemia is one of the known causes of dense metaphyseal bands. Trope et al found that that magnetic resonance spectroscopy (MRS) may have a role as a noninvasive technique for the in vivo examination of the brain of children exposed to lead. Beverly P Wood, MD, MSEd, PhD is a member of the following medical societies: American Academy of Pediatrics, Association of University Radiologists, American Association for Women Radiologists, American College of Radiology, American Institute of Ultrasound in Medicine, American Medical Association, American Roentgen Ray Society, Radiological Society of North America, Society for Pediatric RadiologyDisclosure: Nothing to disclose. The decrease in diastolic cardiac function was more significant in the lead-intoxication group than in the nonexposed group. Infantile scurvy, historically also known as Barlow disease, is named after Sir Thomas Barlow (1845-1945), Professor of Medicine at University College London 1895-1907 5. Become a Gold Supporter and see no third-party ads. It does not occur before six months of age because maternal stores are maintained until then. At the time the article was created Mohammadtaghi Niknejad had no recorded disclosures. Silverman FN, Kuhn JP, Caffey J. Essentials of Caffey's pediatric X-ray diagnosis. At the time the article was last revised Francis Deng had no recorded disclosures. 1993 Apr. Subclinical lead exposure is associated with hyperuricemia. Lead poisoning. 36(2):90-3. They were placed on your computer when you launched this website. Specht AJ, Lin Y, Xu J, Weisskopf M, Nie LH. It is often seen in healthy children, especially after exposure to sunlight after winter. Am Fam Physician. The radiologic "lead band" revisited. Pediatr Clin North Am. 1990 Apr. 2008 Jul-Aug. 659(1-2):166-75. Radiographs revealed profound sclerosis of the metaphyses and epiphyses of the long and short bones in the extremities, with a unique pattern of distribution. [15] In addition, this modality has been utilized to identify health effects resulting from lead exposure, but the equipment is bulky and requires significant maintenance and licensing procedures. Hollerman JJ, Fackler ML, Coldwell DM, Ben-Menachem Y. {"url":"/signup-modal-props.json?lang=us"}, Jones J, Niknejad M, Qureshi P, et al. Initially, the brain develops more neurons and synaptic connections than are needed for function in later life. show answer. Recurrent pericardial effusion due to gunshot wound of the heart in ahemodynamically stable child--a case report. Specht AJ, Lin Y, Weisskopf M, Yan C, Hu H, Xu J, et al. Dense radiopaque bands of bone which are thicker than the adjacent diaphyseal cortex and may form at the metaphysis of growing bones. It is soft, highly malleable, and ductile; it is a poor conductor of electricity. The lead lines may persist after the lead exposure ends. [9, 10]. DeepDyve's default query mode: search by keyword or DOI. Young children undergoing CT or MRI may need heavy sedation or general anesthesia. volume50,pages 877878 (2020)Cite this article. In addition, T2-weighted MRI showed high signal intensity in the periventricular white matter, basal ganglia, insula, posterior thalamus, and pons. Bookmark this article. Postgrad Med J. Unable to process the form. steroids, radiation injury from bone-seeking isotopes (strontium-90, yttrium-90, phosphorus-32), 1. ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. 37 (5):231-46. 1998 Jun. All DeepDyve websites use cookies to improve your online experience. Curr Osteoporos Rep 15:283292, Kurucu N, Akyuz C, Ergen FB et al (2018) Denosumab treatment in aneurysmal bone cyst: evaluation of nine cases. All 3 patients had nonspecific neurologic symptoms of dementia, loss of visual acuity, peripheral neuropathy, syncope, dizziness, nystagmus, easy fatigue, or back pain. In addition, the distal ends of the long bones may disappear and appear clubbed. [QxMD MEDLINE Link]. 1986 Feb. 146(2):245-7. (2010) ISBN: 9781437707922 -, 3. View larger version: In this window In a new window Download as PowerPoint Slide Figure 1. Meyer PA, Brown MJ, Falk H. Global approach to reducing lead exposure and poisoning. 9 (8):e105308. J Environ Biol. Lead encephalopathy: CT and MR findings. If high lead levels persist, growth deformity, such as . Although no distinctive neurologic syndrome could be demonstrated, the incidence of hypertension and hyperuricemia was increased in the affected patients, and serum creatinine levels were increased. 2016. Adv Pediatr. They revealed dense metaphyseal bands at both distal femoral physes with adjacent proximal horizontal bands of radiolucency suggestive of zone of provisional calcification with Trummerfeld zones. Gunshot wounds: 2. The mechanisms of contamination include ingestion, inhalation, prenatal exposure, and dermal exposure, but the most common are ingestion and inhalation. [QxMD MEDLINE Link]. These included striking rickets-like changes and marked osteopenia. Hypovitaminosis C (scurvy). The patient had worked on refurbished houses, removing old paint, and complained of decreased cognition, fatigue, and muscle cramps. [QxMD MEDLINE Link]. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Dense Metaphyseal Bands and Lines. Albers JW, Bromberg MB. The Secret Life of the Periodic Table. Lead poisoning. A: Some of the common causes include chronic anemia, healing rickets and renal osteodystrophy. AJR Am J Roentgenol. Pediatrics. 2007 Apr. Alternating radiolucent and radiodense metaphyseal lines. Findings occur more frequently in younger patients with open epiphyses. [Full Text]. Environ Health Perspect. Dunnion, S., Paterson, A. At the time the article was last revised Dijendra Nath Biswas had no recorded disclosures. Neuroimaging is expensive and the availability may be limited. Neuroimaging, as with CT and MRI, plays a minor role in the diagnosis of lead poisoning. 2002 Dec. 49(6):1285-304, vii. Although the pathophysiologic mechanism of these findings remains poorly understood, it has been suggested that chronic lead exposure be included in the differential diagnosis of unexplained intracranial calcifications in adults. Check for errors and try again. Pediatr Blood Cancer 65, Wang H, Boyce A, Tsai J et al (2014) Effects of denosumab treatment and discontinuation on human growth plates. [21] The subjects' childhood residence and occupational status provided circumstantial evidence of a relationship between excessive lead intake and cerebellar calcification, as seen on CT scans. In addition, lead is used in containers for corrosive liquids (such as sulfuric acid); it may be toughened by the addition of a small percentage of antimony or other metals. STORCH) A: anatomical variation M: metastatic neuroblastoma E: earlier systemic illness ( rickets, scurvy) L: leukemia, lymphoma LINING L: leukemia, lymphoma Certain locations of missile fragments predispose the patient to lead poisoning or lead arthropathy. 1. Raber, S. (1999). At the time the article was created Hani Makky Al Salam had no recorded disclosures. [QxMD MEDLINE Link]. Pediatric Radiology Sachs HK. [QxMD MEDLINE Link]. Shubina O & Dudenkova N. The Effect of Lead on the Process of Spermatogenesis in Sex Glands of Male Albino Rats. Environmental sources may include 6: structural renovation (e.g. 2023 Springer Nature Switzerland AG. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Select data courtesy of the U.S. National Library of Medicine. Unable to process the form. If normal BLLs are maintained, the lead lines gradually decrease in density and disappear after about 4 years. 2013 Nov. 22 (11):2353-7. In 6 infants, there was evidence of multiple lead lines, indicating previous episodes of exposure to lead. & Johnston, R. Dense sclerotic metaphyseal bands caused by denosumab therapy. [QxMD MEDLINE Link]. Submitting a report will send us an email through our customer support system. The neurobiology of brain reorganization during development is also being studied in light of new insights into the molecular mechanisms for activity-dependent neuronal plasticity. Frankel line: dense zone of provisional calcification Trmmerfeld zone: lucent metaphyseal band underlying Frankel line Pelkin spur: metaphyseal spurs that result in cupping of the metaphysis Pelkin fracture: metaphyseal corner fracture Adults osteopenia pathological fractures [25] One, a 10-year-old boy, had elevated blood lead levels (BLLs). dense metaphyseal bands (DMBs) in the proximal aspect of the rst metatarsals J Child Orthop (2008) 2:205-210 207 123. fractures of both proximal humeral metaphyses and Salter-Harris 2 fractures of the distal metacarpals. Distal femoral epiphyses appeared centrally . The authors examined 2 male cousins who were living in the same household. Benson and Price evaluated elderlypersons who grew up in a high-lead environment in Queensland, Australia, and experimental and neuropathologic studies demonstrated an association between exposure to lead and perivascular cerebellar calcification Plain abdominal radiographs may also guide therapy in preventing further absorption through gastrointestinal decontamination. 5. High-resolution MRI and MRS were performed in both children by use of a 3-inch surface coil. Gunshot wounds: 1. Check for errors and try again. 17(4):419-23. OMD is a rare sclerosing bone disorder inherited in an autosomal recessive manner. Silverman FN, Kuhn JP, Caffey J. Essentials of Caffey's pediatric X-ray diagnosis. Normal bone is laid down on the epiphyseal side of the lead line; with recovery, the lead line becomes broader and less dense and may eventually disappear. Biochemistry, Heme Synthesis. [QxMD MEDLINE Link]. The brother's lead levels were not elevated; an androgen receptor mutation identified on the X chromosome in both brothers confirmed the diagnosis of X-linked bulbospinomuscular atrophy. Ahlgren et al used x-ray fluorescence analysis to determine the lead concentration in vivo of 5 former workers in a metal industry and found that their lead levels were about 3-9 times higher than levels found in people from southern Sweden. Cellular and Molecular Toxicity of Lead in Bone. Differential diagnosis Common chronic anemia, e.g. Aminat S. Ogun, Neena V. Joy, Menogh Valentine. Perelman S, Hertz-Pannier L, Hassan M, Bourrillon A. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Woolf and associates examined 15 Omani infants (2-4 mo of age) who had acute lead encephalopathy and concluded that any young infant presenting with unexplained encephalopathy should undergo radiography of the knee and that, in such cases, the presence of opaque metaphyseal bands strongly supports the diagnosis of lead poisoning. bleeding gums, petechiae), and impaired wound healing. Males and females are equally affected. Pica. Presenting features vary as a function of factors such as age (pediatric predisposition to more severe neurologic toxicity), ingested dose, and chronicity of exposure. More specifically, they found significant reductions in the levels of brain metabolites in gray matter but not white matter in individuals exposed to lead. Although in both children the MRI scans were normal, the lead-exposed boy had significant alterations in brain metabolites, with a reduced ratio of N -acetylaspartate to creatine in both gray matter and white matter. Case study, Radiopaedia.org (Accessed on 02 May 2023) https://doi.org/10.53347/rID-83195. Anteroposterior radiograph of the wrist obtained in a 2-year-old boy reveals a dense metaphyseal band (arrow) in the distal radius, without flaring or cupping. [16] A portable x-ray fluorescence (XRF) device has been developed to overcome these disadvantages, but introduced a measurement dependency on soft tissue thickness. The affected child was also deficient in linguistic skills and attention mechanisms. Arch Environ Health. 2018 Jun 1. [17]. [28] A slightly elevated blood lead level (BLL) of the patient was alarming because of the possibility of subsequent lead poisoning associated with retained pellets. Lead-induced impairments in the neural processes related to working memory function. [QxMD MEDLINE Link]. However, cerebral edema and microhemorrhages may be seen in patients presenting with encephalopathy. 8. Mennel and John reported a case of a 23-month-old boy with osteosclerotic metaphyseal dysplasia (OMD). 2020 May;50(6):877-878. doi: 10.1007/s00247-020-04651-y. [18] The investigators used a questionnaire to gather information about the participants' occupational and environmental lead exposure. 3. [QxMD MEDLINE Link]. These findings suggest that an increase in lead burden leads to an increase in the release of CPK-MB from the myocardial cells and that slight myocardial damage occurs, which might conceivably impair diastolic cardiac function. [Full Text]. If the lead exposure is prolonged, there may be lack of bone modeling. Follis RH, Park EA. Hu H, Milder FL, Burger DE. The symptoms of lead encephalopathy are mainly those associated with cerebral edema. You can see your Bookmarks on your DeepDyve Library. Am J Roentgenol Radium Ther Nucl Med. Am J Public Health. Medscape Education, 20021011549-overviewDiseases & Conditions, encoded search term (Lead Poisoning Imaging) and Lead Poisoning Imaging, Botulinum Toxin Injections in Plastic Surgery, Pathophysiology and Etiology of Lead Toxicity, EMA Panel Recommends DPD Testing Prior to Fluorouracil Treatment, Panel Backs Limited New Olaparib Use in Prostate Cancer, 'Snake Oil' Fake Cures for Long COVID Leave Patients at Risk, 10 Cases of Food Poisoning: Find the Pathogen Responsible. 2001 Jun. Its chemical symbol Pb,is short for plumbum, the Latin word for lead. Caffeys Pediatric Diagnostic Imaging, 11th Ed. J Neurol Neurosurg Psychiatry. Wani AL, Ara A, Usmani JA. You can use Radiopaedia cases in a variety of ways to help you learn and teach. Symmetric dense metaphyseal bands are noted in the lower end of femur and upper end of tibia and fibula. Mild flaring along metaphyseal corners was noted at distal femoral metaphysis suggestive of Pelkan spurs. At the time the article was last revised Mohammadtaghi Niknejad had Reference article, Radiopaedia.org (Accessed on 02 May 2023) https://doi.org/10.53347/rID-65973, View Dijendra Nath Biswas's current disclosures, see full revision history and disclosures, alternating lucent and dense metaphyseal bands. {"url":"/signup-modal-props.json?lang=us"}, Khan I, Dense metaphyseal bands. {"url":"/signup-modal-props.json?lang=us"}, Niknejad M, Bell D, Deng F, et al. Find any of these words, separated by spaces, Exclude each of these words, separated by spaces, Search for these terms only in the title of an article, Most effective as: LastName, First Name or Lastname, FN, Search for articles published in journals where these words are in the journal name, /lp/radiological-society-of-north-america-inc/the-dense-metaphyseal-band-sign1-T1YzHA6HGA, Raber, Scott A.

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