‘Ring sign’ is seen in: September 2003
**Core Concept**
The "ring sign" refers to a radiological finding characterized by a ring-like appearance on imaging, specifically in the context of scurvy. Scurvy is a disease caused by vitamin C deficiency, leading to collagen synthesis impairment and connective tissue damage. The ring sign is a manifestation of this damage in the bone.
**Why the Correct Answer is Right**
In scurvy, the ring sign is observed due to the formation of a ring-like periosteal reaction in response to the bone's attempt to repair the damage caused by vitamin C deficiency. This reaction leads to a characteristic radiographic appearance, where a ring of new bone formation is seen around the affected area. The periosteum, a layer of connective tissue surrounding the bone, becomes involved in the repair process, resulting in the formation of a ring-like structure.
**Why Each Wrong Option is Incorrect**
**Option B:** Congenital syphilis is associated with a variety of radiological findings, including "saber shin" deformity, but not the ring sign.
**Option C:** Gaucher's disease is a lysosomal storage disorder that affects the bone marrow and causes bone lesions, but it is not associated with the ring sign.
**Option D:** The ring sign is not seen in all of the above conditions, making this option incorrect.
**Clinical Pearl / High-Yield Fact**
The ring sign is a classic radiological finding in scurvy, but it can also be seen in other conditions such as osteosarcoma. However, the presence of scurvy should be considered in any patient with a ring sign, especially in the context of a recent history of poor nutrition or malabsorption.
β Correct Answer: A. Scurvy