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(RadioGraphics. 1983;3:315-323.)
© RSNA, 1983

Pencil pointing

A vascular pattern of deossification

Anne C. Brower M.D.1 and Robert M. Allman M.D.2

1 From the Department of Radiology, The George Washington University Hospital, Washington, D.C.
2 From the Department of Radiology/Nuclear Medicine, Uniformed Services University of the Health Sciences, School of Medicine, Bethesda, Maryland.

Radiographic patterns of deossification conform to the internal vascular anatomy of the bone, not to a specific disease. Alterations in blood flow to a specific vascular bed within the bone produce a specific radiographic pattern. "Pencil pointing", a result of hyperemia and deossification in the metaphyseal cutback and epiphyseal articular bed, is a characteristic pattern seen in many different diseases.

Index Terms: Arthritis • Bones • blood supply • Osteoporosis • Psoriasis






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