Radiological zebra lines correspond to bisphosphonate administration in children with osteogenesis imperfecta

Bisphosphonates are widely used in the treatment of osteogenesis imperfecta due to their action of limiting bone resorption by inhibiting osteoclast activity. Sclerotic bands, which are known as metaphyseal lines, are observed in the metaphysis of the long bones in paediatric patients treated with bisphosphonates for osteogenesis imperfecta before closure of the growth plate, and the number of metaphyseal lines corresponds to the number of treatment cycles. Metaphyseal lines are sometimes called 'radiological zebra lines'. This report of two paediatric patients with osteogenesis imperfecta receiving cyclic bisphosphonates describes the pattern of radiological zebra lines corresponding to bisphosphonate administration. The distances between the lines show an increasing interval towards the diaphysis in growing bones.