Musculoskeletal ImagingLooser's zones
(Emil Looser, 1877 - 1936, Swiss surgeon), radiolucent areas occurring at right angles to the cortex and extending across a portion of the bone diameter (Fig.1). These zones are also known as pseudofractures and are considered to be a type of insufficiency stress fracture.
Looser's zones are seen in persons with osteomalacia, chronic renal disease, fibrous dysplasia, hyperthyroidism, Pagets disease, renal osteodystrophy and X linked hypophosphataemia.
Characteristic sites of involvement are the axillary margins of the scapula, ribs, pubic rami, proximal end of the femur, and ulna. Frequently the pseudofractures are bilateral, and the intraosseous margins reveal sclerosis. See osteomalacia (III:1), Fig. 1, osteomalacia (III:1), Fig. 2.
DR/RB
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AP (a) and lateral (b) radiographs of the leg demonstrate horizontally orientated linear lucencies in the tibia in a patient with dilatin-associated osteomalacia.
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Looser's zones, Fig.1 (a) | | Looser's zones, Fig.1 (b) | |