White line of Frenkel is seen in: September 2008

Ans. C: Scurvy Clinical symptoms and signs of infantile scurvy, in order of frequency are irritability, tenderness and weakness of lower extremities, a scorbutic rosary of the legs, bleeding of the gums (usually where teeth have erupted), and fever. Radiographic findings of scurvy: Dense metaphyseal line-This is due to an intensification of the zone of preparatory calcification, resulting from matrix formation failing, is has been referred to as the white line of Frenkel, but is non-specific, as it is also seen in healing rickets, and lead or phosphorus poisoning. Ground glass osteoporosis: This appears at the end of the shaft with blurring or disappearance of trabecular markings. Halo ossification centre: Also called the Wimberger's ring, it is the same effect that produces the white line of Frenkel, affecting the epiphyseal ossification center. Corner sign-Seen due to subepiphyseal infarction, or separation of the epiphysis from the metaphysis. Lateral spurs-These metaphyseal spurs project at right angles to the axis of the shaft, they may be seen due to mushrooming of epiphysis on the metaphysis, or may represent earliest calcification of periosteum elevated by a subperiosteal hemorrhage. Subperiosteal hematomas-These occur at the end of long bones, seen after about 2 weeks of onset of clinical symptoms; it is not the periosteal hemorrhage that calcifies, but the elevated periosteum, secondary to resumption of bone formation. Metaphyseal fractures-Subperiosteal comminuted fractures at the end of long bones, extending only paially through the width of the bone. Atrophy scurvy line-A radiolucent zone on the shaft side of Frenkel's white line, it has been referred to as the Trummerfeld Zone.