Lead toxicity and management of gunshot wounds in the lumbar spine. Become a Gold Supporter and see no third-party ads. Bookmarks. Clinical manifestations vary, ranging from mild (or asymptomatic) cases to a severe life-threatening encephalopathy 6. The patient in the study by Schrote et al had a 25-year history of normochromic normocytic anemia with moderate basophilic stippling, mild renal failure, hyperuricemia, and abnormal porphyrins. To get new article updates from a journal on your personalized homepage, please log in first, or sign up for a DeepDyve account if you dont already have one. The decision was made at this time to commence treatment with pamidronate. Presenting features vary as a function of factors such as age (pediatric predisposition to more severe neurologic toxicity), ingested dose, and chronicity of exposure. 101(6):E7. MMWR Recomm Rep. 2007 Nov 2. X-ray fluorescence measurements of lead burden in subjects with low-levelcommunity lead exposure. Vitamin C is essential for collagen synthesis, acting as a coenzyme to producing cross-linking of collagen fibers. & Johnston, R. Dense sclerotic metaphyseal bands caused by denosumab therapy. [QxMD MEDLINE Link]. Previous autopsy studies have shown that cerebellar calcification is more common in Queensland than elsewhere. [QxMD MEDLINE Link]. OMD is a rare sclerosing bone disorder inherited in an autosomal recessive manner. 2016;9(10):1129-34. The evolution of the radiologic lead line. Radiology. Usama Munir, MBBS, FRCS Orthopedic Surgeon, Department of Surgery, Whiston Hospital, UKDisclosure: Nothing to disclose. 2018 Jun 1. [QxMD MEDLINE Link]. Mennel EA, John SD. Metaphyseal lesions and periosteal reaction of long bones in a child Lead environmental pollution is a major health hazard throughout the world. Tax calculation will be finalised during checkout. At the time the article was created Abhi Datir had no recorded disclosures. Silverman FN, Kuhn JP, Caffey J. Essentials of Caffey's pediatric X-ray diagnosis. Select data courtesy of the U.S. National Library of Medicine. 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. Kulshrestha M. Lead Poisoning Diagnosed by Abdominal X-Rays. Reference article, Radiopaedia.org (Accessed on 02 May 2023) https://doi.org/10.53347/rID-8549. Generalized increased bone density in children | Radiology Reference (2003) ISBN: 9780702026508 -, 5. 50(4):337-40. 38 (3):575-585. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. no financial relationships to ineligible companies to disclose. [Full Text]. All 3 patients had nonspecific neurologic symptoms of dementia, loss of visual acuity, peripheral neuropathy, syncope, dizziness, nystagmus, easy fatigue, or back pain. [QxMD MEDLINE Link]. [7]. 1990 Apr. 1952;68 (5): 709-24. Neurologic toxicity and hematologic toxicity are common features. ADVERTISEMENT: Supporters see fewer/no ads. These abnormalities suggest that the underlying defect in type V OI may involve a molecule common to both bone and cartilage that is involved in the regulation of growth plate development and metadiaphyseal . 2001 Jun. The patient's brother worked part-time with him and developed similar findings; in addition, the brother had difficulty chewing and experienced dysphagia, perioral twitching, gynecomastia, and multifocal denervation of extremity and facial muscles. All DeepDyve websites use cookies to improve your online experience. Lead poisoning. 9 (8):e105308. In the study by Hu et al, 18 patients had bone lead levels below the measurement uncertainty. Interpreting and managing blood lead levels < 10 microg/dL in children and reducing childhood exposures to lead: recommendations of CDC's Advisory Committee on Childhood Lead Poisoning Prevention. A workup was notable for nephrocalcinosis on imaging; dense, metaphyseal bands on radiography of the hands; and calcium deposition in the cornea and skin. His cousin, who was not exposed to lead, had normal neuropsychological function. Hollerman et al describe the substantial contribution radiologists can make to the evaluation and treatment of the patient with a gunshot wound. 5. The presence of lead foreign bodies in the gastrointestinal tract (caused by pica) may highlight the diagnosis and prompt immediate intervention. 2. 2020 May;50(6):877-878. doi: 10.1007/s00247-020-04651-y. Trope I, Lopez-Villegas D, Lenkinski RE. Fassin D, Naud AJ. Learn more about Institutional subscriptions, Park H, Yang S, Sheppard W et al (2016) Current management of aneurysmal bone cysts. Check for errors and try again. [QxMD MEDLINE Link]. If you log out, you will be required to enter your username and password the next time you visit. PubMedGoogle Scholar. They were placed on your computer when you launched this website. Poznanski AK. CLINICAL VIGNETTE JBMR - American Society for Bone and Mineral Research These patterns were found in the subcortical area, basal ganglia, vermis, and cerebellum. 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. Tutar HE, Atalay S, Uysalel A, et al. 3. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDEwMTEzLW92ZXJ2aWV3. Dhnert WF. Semantic Type: Finding Semantic ID: T033 Concept ID: C4020919 ID . Dense metaphyseal bands HP:0100959 Dense radiopaque bands of bone which are thicker than the adjacent diaphyseal cortex and may form at the metaphysis of growing bones. Also, see eMedicineHealth's patient education article Poisoning. Ultrasonography is not routinely used in the diagnosis of lead intoxication, though transcranial sonography may be used to investigate congenital lead poisoning and lead intoxication in infant patients presenting with lead encephalopathy. [QxMD MEDLINE Link]. 1994 Apr. Pediatr Clin North Am. Scurvy in adults is rare. This change was evidenced by increased A values and decreased E values and E/A ratios. Pounds J, Long G, Rosen J. The symptoms of lead encephalopathy are mainly those associated with cerebral edema. 626:96-98. Because lead and calcium are used interchangeably by bone, lead deposition occurs in high concentrations in growing bones; the greatest concentration occurs in the metaphyses, particularly those in the distal femora, ends of the tibiae, and distal radii, because these are the parts of the skeleton that grow most rapidly. 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. Sci Total Environ. Radiographic findings in congenital lead poisoning. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Follis RH, Park EA. For excellent patient education resources, visit eMedicineHealth's First Aid and Injuries Center. Evolution of the radiographic appearance of the metaphyses - PubMed High-resolution MRI and MRS were performed in both children by use of a 3-inch surface coil. It is soft, highly malleable, and ductile; it is a poor conductor of electricity. Radiology of syndromes, metabolic disorders, and skeletal dysplasias. Ingestion is more common in children, while the inhalation route is more frequent in occupationally exposed adults. Curr Osteoporos Rep 15:283292, Kurucu N, Akyuz C, Ergen FB et al (2018) Denosumab treatment in aneurysmal bone cyst: evaluation of nine cases. [QxMD MEDLINE Link]. Part of Springer Nature. Sources of occupational and recreational exposures include: automobile work (especially related to radiators). Dense sclerotic metaphyseal bands caused by denosumab therapy - Springer Raber, S. (1999). [QxMD MEDLINE Link]. Other significant manifestations in both children and adults arise from the propensity for bleeding, including intra-articular, retrobulbar, and intracranial hemorrhage. (2016) ISBN: 9781844039104 -, 6. no financial relationships to ineligible companies to disclose. Dense metaphyseal bands Read and print from thousands of top scholarly journals. osteopetrosis; pyknodysostosis; metabolic. A negative radiograph does not rule out lead poisoning in children. 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. Subclinical lead exposure is associated with hyperuricemia. skeletal dysplasias. Hu et al measured bone lead levels in 34 adults with no known history of excessive lead exposure and found that bone lead levels were greater in older persons; they concluded that theKXRF technique may help distinguish low levels of lead burden, as shown in epidemiologic studies. With chronic exposure to lead, patchy calcifications may be seen on CT scans in adults. At the time the article was last revised Francis Deng had no recorded disclosures. These included striking rickets-like changes and marked osteopenia. The decrease in diastolic cardiac function was more significant in the lead-intoxication group than in the nonexposed group. Lead has been used extensively since ~7000 BCE 5. Flora SJ. Become a Gold Supporter and see no third-party ads. OS patients treated with pamidronate can develop metaphyseal sclerotic bands as well as epiphyseal and vertebral endplate sclerosis progressing to a bone-within-bone appearance. [18] The investigators used a questionnaire to gather information about the participants' occupational and environmental lead exposure. drug or hormone therapy in high dosage,e.g. AD: IFITM5/BRIL: VI: Moderate to severe skeletal deformity. He had a depressed affect, postural tremor, right-arm weakness with partial denervation on electromyelography, and borderline-low sensory nerve action potential amplitudes. Osteosclerotic metaphyseal dysplasia: a skeletal dysplasia that may mimic lead poisoning in a child with hypotonia and seizures. Vet World. Sclerosis involved the anterior ribs, iliac crests, talus, and calcaneus. Lead poisoning or plumbismrefers to the multi-organ toxicity exerted by exposure to lead. Sign up today, get DeepDyve free for 14 days. Common causes of dense transverse metaphyseal lines can be remembered using the mnemonics: DENSE LINES PRINCES Mnemonics DENSE LINES D: D-vitamin intoxication E: elemental arsenic and heavy metals ( lead, bismuth, phosphorus) N: normal variation S: systemic illness E: estrogen to mother during pregnancy L: leukemia, lymphoma I infection ( TORCH) 136(1):83-4. These bands are not pathognomonic, and the differential diagnosis for cases involving opaque metaphyseal lines is wide and includes poisoning with other heavy metals; hypervitaminosis D; and the healing stages of leukemia,rickets, andscurvy. Several mental retardation syndromes and cognitive disorders have been recognized as being secondary to genetic disruption of intracellular signaling cascades. 1996;34(1):107-8. (2003) ISBN: 0323023282 -, 2. CAS Bullets, ballistics, and mechanisms of injury. Radiology Review Manual. 17(4):419-23. Phenotypically indistinguishable from type IV OI. Johnston MV, Nishimura A, Harum K, et al. 1988 May. Meyer PA, Brown MJ, Falk H. Global approach to reducing lead exposure and poisoning. At the time the article was created Owen Kang had no recorded disclosures. [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. [QxMD MEDLINE Link]. [24]. Price excludes VAT (USA) 1. Part 4 Musculoskeletal Imaging | Radiology Key A clinical diagnosis of transient synovitis was made. Bone changes in hematologic disease. Schrote and associates reported a case of a 59-year-old potter who presented with lead polyneuropathy after 37 years of occupational exposure and noted that cranial CT showed extensive, bilateral, symmetrical calcification in the cerebellar hemispheres and minor calcification in the subcortical area of the cerebral hemispheres and basal ganglia. If normal BLLs are maintained, the lead lines gradually decrease in density and disappear after about 4 years. [19], CT plays a minor role in the diagnosis of lead poisoning. 7. Albers and Bromberg reported a case of X-linked bulbospinomuscular atrophy, or Kennedy disease, masquerading as lead neuropathy. Omare M, Kibet J, Cherutoi J, Kengara F. A Review of Tobacco Abuse and Its Epidemiological Consequences. Physiol Meas. Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR is a member of the following medical societies: American Association for the Advancement of Science, American Institute of Ultrasound in Medicine, British Medical Association, Royal College of Physicians and Surgeons of the United States, British Society of Interventional Radiology, Royal College of Physicians, Royal College of Radiologists, Royal College of Surgeons of EnglandDisclosure: Nothing to disclose. Distal femoral epiphyses appeared centrally . The common occurrence of renal impairment in these patients may be the result of associated lead nephropathy. Evidence suggests that cerebellar calcification is a marker of previous lead intoxication. 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. Unable to process the form. Now presented with severe knee pain. 37 (5):231-46. 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. J Clin Endocrinol Metab 99:39543955, Department of Paediatric Radiology, Royal Belfast Hospital for Sick Children, 180 Falls Road, Belfast, BT, 12 6BE, UK, Department of Paediatric Oncology/Haematology, Royal Belfast Hospital for Sick Children, Belfast, UK, You can also search for this author in In addition, T2-weighted MRI showed high signal intensity in the periventricular white matter, basal ganglia, insula, posterior thalamus, and pons. Defective collagen cross-linking compromises skin, joint, bone, and vascular integrity. Mosby Inc. (1996) ISBN:0815187092. Lucent transverse metaphyseal lines (mnemonic). Arch Pediatr Adolesc Med. Dense metaphyseal bands (Concept Id: C4020919) - National Center for 1991;91:17-32. Radiological Society of North America, Inc. With chronic exposure to lead, patchy calcifications may be seen on MRI scans (though these are better seen on CT scans). methotrexate View Mohammadtaghi Niknejad's current disclosures, see full revision history and disclosures, alternating radiolucent and radiodense metaphyseal lines. Disturbance of enchondral bone formation can produce lucent metaphyseal bands (red arrows are oval) as in this patient with leukemia. 8. Pica. Because the patient was asymptomatic, left ventriculotomy was not used to extract the pellet; only pericardial tube drainage was carried out. [QxMD MEDLINE Link]. Ralph Weissleder, Jack Wittenberg, Mukesh G. Harisinghani. In healthy infants 3 years of age or younger, the finding of increased metaphyseal opacity is not unusual. Reference article, Radiopaedia.org (Accessed on 02 May 2023) https://doi.org/10.53347/rID-10519. Ahlgren L, Liden K, Mattsson S, Tejning S. X-ray fluorescence analysis of lead in human skeleton in vivo. [23]. Pediatrics. View larger version: In this window In a new window Download as PowerPoint Slide Figure 1. Case 4: bisphosphonate therapy - osteogenesis imperfecta, View Mohammadtaghi Niknejad's current disclosures, see full revision history and disclosures, Alternating lucent and dense metaphyseal bands. Perelman et al reported a case in which MRI results excluded a focal mass, and early treatment of edema prevented neurosurgical exploration. The Roentgenogram in Early Scurvy. Chelation therapy led to an increase in urine lead excretion without symptomatic improvement. 2008 Jul-Aug. 659(1-2):166-75. Evolution of the radiographic appearance of the metaphyses over the Dunnion, S., Paterson, A. Fortschr Neurol Psychiatr. Update on the clinical management of childhood lead poisoning. By excluding more serious causes, this finding was proved to be a normal variant. Dense metaphyseal bands (differential). ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Metaphyseal Bands - Syndrome Omim - RR School Of Nursing Dense sclerotic metaphyseal bands caused by denosumab therapy Pediatr Radiol. Check for errors and try again. Muscle Nerve. Angiology. Findings occur more frequently in younger patients with open epiphyses. Environ Health Perspect. 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 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. Share cases and questions with Physicians on Medscape consult. Defective bone absorption can "wax and wane," leading to alternating dense and lucent metaphyseal bands and a bone-in-bone appearance. [6]. 2022. Reyes PF, Gonzalez CF, Zalewska MK, Besarab A. Intracranial calcification in adults with chronic lead exposure. (2011) ISBN:1609139437. Anton Sebastian. In select cases, abdominal radiographs may demonstrate lead-containing paint chips (resulting from pica) or other lead-containing objects. Lead is a bluish-white metal of bright luster. Skeletal features of primary hyperoxaluria type 1, revisited If the lead exposure is prolonged, there may be lack of bone modeling. You can see your Bookmarks on your DeepDyve Library. Mosby Inc. (1996) ISBN:0815187092. Am J Public Health. Dense metaphyseal bands or lead lines indicate radioopaque bone at the metaphysis of growing bones and are fairly typical of lead poisoning in young infants with acute encephalopathy. {"url":"/signup-modal-props.json?lang=us"}, Datir A, Carroll D, Bell D, et al. Correspondence to Authors Shane Dunnion 1 , Anne Paterson 2 , Robert Johnston 3 Affiliations 1 Department of . Magnetic resonance imaging and spectroscopy of regional brain structure in a 10-year-old boy with elevated blood lead levels. Rentfrow B, Vaidya R, Elia C, Sethi A. "The Dense Metaphyseal Band Sign1.". Disrupted brain plasticity is not confined to cases of lead intoxication; other clinical disorders, such as metabolic and epileptic encephalopathies, as well as psychosocial deprivation, may be associated with disrupted brain plasticity. [QxMD MEDLINE Link]. Hollerman JJ. 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 Plain abdominal radiograph in a 3-year-old patient shows multiple metallic particles due to ingested flakes of lead paint. {"url":"/signup-modal-props.json?lang=us"}, Khan I, Dense metaphyseal bands. [17]. Biomed Environ Sci. Lead exposure: health effects, prevention and treatment. BLLs were normal. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Lead poisoning | Radiology Reference Article | Radiopaedia.org sickle cell disease , thalassemia chemotherapy, e.g. pedi [Nick's Radiology Wiki] bleeding gums, petechiae), and impaired wound healing. (1990) ISBN:0815176848. Pediatr Blood Cancer 65, Wang H, Boyce A, Tsai J et al (2014) Effects of denosumab treatment and discontinuation on human growth plates. 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. 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. J Trop Pediatr. In children, the density and width of the lead bands are well correlated with the concentration of lead ingestion or inhalation, as well as with the duration of lead exposure. The pellet was localized by means of 2-dimensional echocardiography of the left ventricular apical wall. A workup was notable for nephrocalcinosis on imaging;. 1975;51(601):765-9. 2023 DeepDyve, Inc. All rights reserved. [QxMD MEDLINE Link]. Biochemistry, Heme Synthesis. This increased metaphyseal opacity is a normal variant and represents exuberant calcification of the zone of provisional calcification. 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. Scand J Work Environ Health. They appear on radiographs as bone that is more radiopaque that the adjacent diaphyseal cortex. Dense metaphyseal bands (differential) Last revised by Francis Deng on 29 Jan 2020 Edit article Citation, DOI, disclosures and article data The differential diagnosis of dense metaphyseal bands is wide. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. 56:1-16. 2021;:1-16. The presence of lead foreign bodies in the gastrointestinal tract may highlight the diagnosis and prompt immediate intervention. Am Fam Physician. The syndrome is clinically characterized by developmental delay of a progressive nature, hypotonia, elevated alkaline phosphatase levels, and late-onset spastic paraplegia. Wolfgang Dhnert. Both underwent a comprehensive neuropsychological evaluation. Fortschr Rontgenstr. Pediatrics. 2. Anecdotal reports of angiography and ultrasonography used in the diagnosis of lead poisoninghave appeared in the literature. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Dense Metaphyseal Bands and Lines. Stephen Chapman, Richard Nakielny. 2(2):82-6. {"url":"/signup-modal-props.json?lang=us"}, Salam H, Deng F, Bell D, et al. Males and females are equally affected. Opaque metaphyseal bands are also seen after poisoning with other heavy metals; with hypervitaminosis D; and during the healing stages of leukemia, rickets, and scurvy. [from HPO] Term Hierarchy GTR MeSH CClinical test, RResearch test, OOMIM, GGeneReviews, VClinVar Year Book Medical Pub. Unable to process the form. This may sometimes be pronounced and may lead to a false-positive diagnosis of lead intoxication. Sculpting the developing brain. Wonders of Radiology.

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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 ). [QxMD MEDLINE Link]. View Hani Makky Al Salam's current disclosures, see full revision history and disclosures, chronic recurrent multifocal osteomyelitis, alternating radiolucent and radiodense metaphyseal lines, Differential diagnosis of dense metaphyseal bands, normal variant:especially in a neonate - dense zone of provisional calcification, deprivation (psychosocial) dwarfism with trauma. Check for errors and try again. Table 1. [Classification and Clinical Features of Osteogenesis Plain radiography of the knee is an inexpensive and widely available investigation that may be rapidly performed. [1, 2, 3, 4, 5], Plain skeletal radiographs have been used extensively in the diagnosis of lead poisoning in children. [22]. Exposure to lead appears to selectively alter metabolism of cortical gray matter. Common sources of exposure to this ubiquitous metal may be broadly classified as occupational (or recreational), environmental, or perinatal (primarily trans-placental). Lucent transverse metaphyseal lines (mnemonic) - Radiopaedia 48:1-38. MRI may demonstrate how the brain's functional maps undergo major reorganization in response to early environmental changes. To save an article, log in first, or sign up for a DeepDyve account if you dont already have one. 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 Dense Metaphyseal Band Sign1, Radiology | DeepDyve We'll do our best to fix them. StatPearls Publishing. A finding of disruption of brain plasticity, as seen on MRIs, is not a finding unique to lead intoxication. The radiologic "lead band" revisited. Radiology Review Manual. Silverman FN, Kuhn JP, Caffey J. Essentials of Caffey's pediatric X-ray diagnosis. Neuroimaging is expensive and the availability may be limited. Clin Med (Lond). Pediatr Clin North Am. Primary Hyperoxaluria | NEJM 26(3):479-81. 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. 2002 Dec. 49(6):1285-304, vii. His cousin, a 9-year-old boy, had not been exposed to lead. 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. 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. Radiology. Become a Gold Supporter and see no third-party ads. Specht AJ, Lin Y, Weisskopf M, Yan C, Hu H, Xu J, et al. J Environ Biol. Learning Radiology - Lucent Metaphyseal Bands in Leukemia lead. https://doi.org/10.1007/s00247-020-04651-y. 1998 Jun. The differential diagnosis of dense metaphyseal bands is wide. AJR Am J Roentgenol. The patient had worked on refurbished houses, removing old paint, and complained of decreased cognition, fatigue, and muscle cramps. Osseous changes occurred on CT in 69% of patients, and on computed chest radiography in 53%. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. Biomarkers. In 4 infants, lead lines were also seen in the axial skeleton. Bone lead levels in an environmentally exposed elderly population in shanghai, China. Differential Diagnosis. "Dense metaphyseal bands"[Clinical Features] OR 866573[uid] - MedGen Result 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.