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Patient History



Physical Exam and Laboratory


PA :: XR - Plain Film :: ACR Code: 4.1

Sclerosing Bone Dysplasias

Diffuse tiny bone islands involving the sacrum, iliac, ischial, pubic bones and femoral heads bilaterally.

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Summary of Findings

Diffuse tiny bone islands involving the sacrum, iliac, ischial, pubic bones and femoral heads bilaterally.


Differential Diagnosis

Metastatic disease (however it would be highly rare for metastatic disease to be bilateral, symmetric, and in typical locations for osteopoikolosis)


Diagnosed by:

OSTEOPOIKILOSIS Sclerosing Bone Dysplasias

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Treatment and Followup

None. Incidental, benign finding.


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This Image: 22268 - is linked to Topic: 4695

Topic: OSTEOPOIKILOSIS Sclerosing Bone Dysplasias

The sclerosing bone dysplasias are a heterogeneous group of developmental anomalies resulting from inborn errors of bone metabolism causing various patterns of increased bone density. This metabolic disruption may be secondary to either excessive osteoblastic activity or failure in osteoclastic activity during skeletal maturation and/or remodeling. Examples of benign abnormalities in this family of bone dysplasias are enostoses, osteopathia striata and osteopoikilosis

Osteopoikilosis is an autosomal dominant, asymptomatic disorder that is most often an incidental finding of multiple round, clustered areas of bony sclerosis (bone islands). The most common areas affected are the articular ends of bone, particularly the epiphyses, the metaphyses of long bones, and the pelvis. The individual lesions characteristic of osteopoikilosis are uniform densities, contained within the spongiosa and are oriented parallel to the alignment of the bony trabeculae. Some patients (approximately 25%) may have associated subcutaneous fibrous nodules. Although most cases are inheritated, there have been sporadic cases reported.

In osteopoikilosis plain films are often sufficient for diagnosis; however, the differential can include osteoblastic metastatic lesions. Bone scintigraphy is most often normal in osteopoikilosis, unlike in metatstatic disease, which demonstrates increased uptake of the radiopharmaceutical.

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Sclerosing Bone Dysplasias
Diffuse tiny bone islands involving the sacrum, iliac, ischial, pubic bones and femoral heads bilaterally.
Image Modality: XR - Plain Film
Image Plane: PA
Image/Caption Source: Glenn Richard
MedPix™ Caption 22268
Caption/Image Contributor: Glenn Richard - Author Info :: Send Email
Affiliation: National Naval Medical Center Bethesda

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    TF Case Contributor Credits
    Topic Author(s): 2728
    Submitted by: Glenn Richard - Author Info
    Case/Image Editor: Elizabeth A. McGuigan - Editor Info

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