Question: What is the differential diagnosis for the radiologic finding known as the “dense metaphyseal band sign?
Answer: While the most common cause for finding of a dense metaphysis on a plain radiograph is as a normal variant in healthy children, the cited reference discusses the differential diagnosis for this finding as follows:
“The dense metaphyseal band sign enables a lengthy differential diagnosis. In order of decreasing frequency, the causes of a dense metaphysis include plumbism, treated leukemia, healing rickets, other heavy metal (arsenic, bismuth, mercury) poisoning, recovery from scurvy, vitamin D hypervitaminosis, congenital hypothyroidism, hypoparathyroidism, and transplacental infections (e.g. toxoplasmosis, rubella, cytomegalovirus, and herpes). (Raber SA. The dense metaphyseal band sign. 1999 Radiology 211:773-774)