Presentation
Tooth decay and right hip pain.
Patient Data
Dense bones in keeping with osteopetrosis.
There are multiple areas of bone lysis and destruction related to the teeth most likely due to areas of ulceration and infection.
Images of the pelvis and dedicated views of the hips obtained without prior imaging for comparison.
Bones demonstrate dense sclerosis in keeping with the history of osteopetrosis. There are extensive degenerative changes of the right hip where there is the distortion of the acetabulum and superior displacement of the femoral head. There is thinning of the articular surface, and the femoral head is abnormally flattened and square shaped. The femoral neck is foreshortened. There appears to be a lucent line through the shaft of the upper femur which may be in keeping with old fixation across a fracture in this location. The left hip demonstrates only minor degenerative changes with early osteophytic lipping noted. Comparison with previous films would be helpful to assess the degree of progression of the degenerative changes involving the right hip.
Case Discussion
This patient has osteopetrosis from birth. This condition is also known as marble bone disease.
His main complaints have been recurrent dental infections and chest infections difficult to eradicate.
His OPG shows evidence of long-standing and recurring apical abscess formation.