Celery stalking | Radiology Signs

Celery stalk metaphysis appearance in the metaphysis of long bones on radiographs is caused by conditions producing longitudinal, linear bands of sclerosis and radiolucency in the metaphyseal region. It is characteristically seen in congenital infections such as congenital rubella, congenital syphilis, cytomegalovirus, and toxoplasmosis, as well as in dysplastic bone diseases like osteopathia striata. These pathologies disrupt normal metaphyseal bone development, resulting in alternating bands of increased and decreased bone density visible on plain radiographs. Clinically, these patients may present with antenatal or perinatal infections (TORCH complex) or asymptomatic bone dysplasia.

Why is it called so?

The name “celery stalk” originates from the resemblance of the metaphyseal radiographic pattern to the longitudinal fibrous stalk of a celery vegetable. The metaphysis shows alternating dense and lucent vertical linear bands mimicking the layered appearance of celery stalks.

Pathophysiology

The sign develops due to abnormal endochondral ossification and metaphyseal remodeling caused by infectious or genetic insults. In congenital infections, inflammation and osteomyelitis disrupt metaphyseal growth plates producing irregular metaphyseal fraying and patchy sclerosis. In osteopathia striata, abnormal bone formation leads to multiple parallel striations of dense bone. These changes produce alternating sclerotic and radiolucent linear bands aligned longitudinally along the metaphysis, creating the characteristic “celery stalk” pattern.

Alternative names: Celery stalk metaphysis

Other associated named signs: None specifically linked but the appearance is part of metaphyseal dysplasia or congenital infection radiological features.