Hypervitaminoses, Hypovitaminoses, Fluorosis, and Lead Poisoning

Chapter 116 discusses hypervitaminoses, including hypervitaminosis A and D, and hypovitaminoses, particularly scurvy and its effects on the musculoskeletal system. Fluoride and lead poisoning are also discussed. The pathophysiology of these diseases and imaging findings are delineated. The main imaging findings of hypervitaminosis A are wavy metaphyseal periostitis in children and enthesopathy in adults. Metastatic calcification is seen with hypervitaminosis D. In scurvy, there is a dense line of the physis, at the zone of provisional calcification, and a lucent metaphyseal band, with possible periosteal elevation caused by subperiosteal hemorrhage. In fluorosis, there is increased bone density and periostitis. In lead poisoning, there are dense metaphyseal bands.