Related Experiment Video
Updated: Jul 14, 2026
Expansion of Human Peripheral Blood γδ T Cells using Zoledronate
Published on: September 9, 2011
Zebra lines of pamidronate therapy in children
M Al Muderis1, T Azzopardi, P Cundy
1Women's and Children's Hospital, 72 King William Road, North Adelaide SA 5006, Australia. munj2@yahoo.com
Insights
Cyclical pamidronate therapy in children creates distinct "zebra lines" in bone metaphyses. These radiographic findings are linked to patient age, growth rate, and dosing, but do not indicate growth deceleration.
Area of Science:
- Pediatric Radiology
- Skeletal Biology
- Pharmacology
Background:
- Pamidronate therapy is increasingly used for pediatric low bone mineral density and fragility.
- Understanding radiographic changes in the growing skeleton during bisphosphonate treatment is crucial.
Purpose of the Study:
- To identify and describe radiographic features of cyclical bisphosphonate therapy in children.
- To characterize the appearance and determinants of metaphyseal banding.
Main Methods:
- Retrospective review of radiographs from 35 children treated with cyclical pamidronate.
- Estimation of physeal growth rates using radiograph band intervals and pamidronate dosing intervals.
Main Results:
- Metaphyseal bands, termed "zebra lines," were observed.
- Band intervals correlated with patient age, growth rate, and dosing regimen.
- No evidence of bone growth deceleration was found in treated children.
Conclusions:
- "Zebra lines" is proposed as a descriptive term for metaphyseal banding in children on cyclical bisphosphonate therapy.
- These findings aid in interpreting radiographic changes associated with pamidronate treatment.
Background:
Pamidronate therapy is increasingly used in children for the treatment of low bone mineral density and increased bone fragility resulting from a spectrum of conditions. The aim of the present study was to determine and describe the radiographic features associated with cyclical bisphosphonate therapy in the growing skeleton.
Methods:
A retrospective review of the radiographs of thirty-five children who had been managed with cyclical pamidronate was carried out. The physeal growth rates were estimated by measuring the band intervals on radiographs and the corresponding time intervals between the administered doses of pamidronate.
Results:
Metaphyseal bands, which we call zebra lines, were observed with band intervals that were dependent on the age of the patient, the rate of growth, and the dosing regimen. Epiphyseal and apophyseal bands were also observed in some patients. A distinction was made between Harris growth arrest lines and zebra lines. There was no evidence to suggest a deceleration in bone growth in children managed with pamidronate.
Conclusions:
The term zebra lines is proposed as a descriptive term for the characteristic pattern of metaphyseal banding seen on the radiographs of children receiving cyclical bisphosphonate therapy.
Related Concept Videos
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
01:31Acid Suppressive Drugs for Peptic Ulcer Disease: Antacids
However, this neutralization reaction between...
01:13Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...