LOOSER'S ZONE

LOOSER'S ZONE

PSEUDOFRACTURE

• focal radiolucent band seen in patients with osteomalacia
• d/t to defect in mineralization
• usually about 2-3mm width

Sites

• ribs
• axillary border of scapula
• pubic rami
• medial cortex of upper femur
• neck of femur
• forearm bones
• metatarsals

Features

• bands initially poorly demarcated – develop to narrow lucency transversing the cortex – no evidence of repair
• painful
• increased uptake in bone scan (more sensitive than X ray)
• physical stress of activity tend to create symmetrical pseudofracture esp pelvic bone
• if undisplaced – responds to treatment – fills and remodels leaving no trace

Conditions causing pseudofracture

• osteomalacia
• rickets
• hypophosphatasia
• renal osteodystrophy
• neurofibromatosis with osteomalacia
• coeliac disease

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