Generalised increased bone density in children

Dr Craig Hacking and Dr Hani Salam et al.

The causes of generalised increased bone density in paediatric patients can be divided accodring to broad categories of cause :

  • skeletal dysplasias
  • metabolic
  • poisoning
    • lead
      • dense metaphyseal bands
      • cortex and flat bones may also be slightly dense
      • modelling deformities later, e.g. flask-shaped femora
    • fluorosis
      • more common in adults
      • usually asymptomatic but may present in children with crippling stiffness and pain
      • thickened cortex at the expense of the medulla
      • periosteal reaction
      • ossification of ligaments, tendons and interosseous membranes
    • hypervitaminosis D
    • chronic hypervitaminosis A
      • not before 1 year of age
      • failure to thrive
      • hepatosplenomegaly
      • jaundice
      • alopecia
      • haemoptysis
      • cortical thickening of long and tubular bones, especially in the feet
      • subperiosteal new bone
      • normal epiphyses and reduced metaphyseal density
      • mandible is not affected
  • idiopathic
    • Caffey disease (infantile cortical hyperostosis)
    • idiopathic hypercalcaemia of infancy : 
      • probably a manifestation of hypervitaminosis D
      • Elfin facies
      • failure to thrive 
      • mental retardation
      • generalized increased density or transverse dense metaphyseal bands
      • increased density of the skull base

There are several mnemonics for dense bones.

See also

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Article information

rID: 12114
Section: Gamuts
Tag: refs
Synonyms or Alternate Spellings:
  • Differential diagnosis of generalized increased bone density in children
  • Generalized increased bone density in paediatrics
  • Generalised increased bone density in paediatrics

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Cases and figures

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    Case 1: osteopetrosis
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    Pyknodysostosis
    Case 2: pyknodysostosis
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    Case 3: renal osteodystrophy with brown tumours
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    Case 4: infantile cortical hyperostosis
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    Prenatal infantil...
    Case 5: infantile cortical hyperostosis
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    Case 6: fluorosis
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