The radiologic "lead band" revisited.

After prolonged heavy metal exposure (e.g., lead) "lead bands" develop at the metaphyseal ends of growing bones. These "lead bands," while a constant finding, are used as additional laboratory evidence to diagnose plumbism. In this study, the role of the proximal fibula in distinguishing physiologic sclerosis from pathologic thickening of the zone of provisional calcification is assessed. In addition, laboratory values are compared to radiographic findings in a controlled fashion to establish levels at which "lead bands" appear. The former is a useful adjunct in the radiographic diagnosis of plumbism, while the minimum blood levels at which "lead bands" are seen is much lower than previously described.