1. SCURVY (cont.)
Epiphyseal separation or fragmentation in the region of metaphysis
Dense , linear calcification at metaphyseal end “ White line of Frankel”
Bony spur “ Pelkan spur “
Transverse radiolucent band “ Scurvy line “
Subperiosteal hematoma

2. Osteoporosis
Thinning of cortex
Thin , dense ring-like epiphysis = Wimberger’s ring
Dense linear calcification at distal metaphysis = White line of Frankel
Bony spur = Pelkan spur
Transverse radiolucent zone = Truemmerfeld zone
Subperiosteal hematoma

4. Neurological Disease in Children

5. NORMAL SKULL FILM CRANIOFACIAL RATIO : Newborn : 4 - 4.5 : 1
2 years : : 1
6 years : : 1
Adult : : 1
SUTURE : Newborn ~ 1cm
3 years ~ 2 mm
Moulding = Parietooccipital overlapping : upto 2 weeks
Sutures close ~ 14 years old

6. NORMAL SKULL FILM cont. FONTANELLE :
Anterior F. close ~ 1.5 years ( months )
Posterior F close ~ 0.5 year ( months )
CONVOLUTIONAL MARKINGS :
Visible at 2 years
Maximal apparence at 4 years
Disappear by 8 years

7. 6 days old

8. F , 10 months old

10. M , 5 years 7 months

12. NORMAL SKULL FILM WORMIAN BONES :
Island of bones within A & P fontanelle, Lambdoid and posterior sagittal sutures
Abnormal in : Cliedocranial disostosis , cretinism , etc.

15. WIDE SUTURES : DDx Increased intracranial pressure :
Obstruction of ventricular system = hydrocephalus
Space occupying lesion +/- hydrocephalus : mass, cyst
Brain edema
Infiltration in sutures
Neuroblastoma
Leukemia
Lymphoma

16. SIGN OF INCREASED INTRACRANIAL PRESSURE
Increased head size and craniofacial ratio
Separation of sutures before 10 years ( esp. in yrs old )
Increased convolutional markings
Pressure change of sella tursica
Anterior wall of dursum sella and posterior clinoid
process
Floor of sellar tursica and posterior wall of dorsum
sella
Enlarged sella tursica and change in shape