Osteopetrosis - autosomal dominant

Case contributed by Dr Abhinav Amarnath Mohan

Presentation

Growth delay in a chronically ill child with a clinical history of progressive deafness and blindness, and organomegaly on examination .

Patient Data

Age: 3 years
Gender: Male
X-ray

Dense bones with a bone within bone appearance. Inverted images show this more clearly. 

Case Discussion

Bone within bone appearance is a classic radiological sign and common spotter radiograph/case study for discussion in postgraduate exams.

In our case the child was treated outside as for provisional diagnosis of thalassemia/sickle cell anemia in view of organomegaly, chronic illness and anemia.

However, on hematological investigations, the provisional diagnosis was ruled out and based on the classical radiological sign, further clinical history and insight (progressive deafness and blindness) the diagnosis of autosomal dominant osteopetrosis was suggested and was confirmed later by the treating physician/pediatrician.

Take home message: the importance of not only recognizing a "classic radiological sign " but eliciting the full clinical history with correlation of signs and symptoms yields the best diagnosis and contributes to a high quality clinical outcome i.e. it emphasizes the invaluable role of the clinical radiologist.

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Case information

rID: 43195
Published: 1st Mar 2016
Last edited: 11th Mar 2019
Inclusion in quiz mode: Included

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