Osteopoikilosis

Case contributed by Dr Andrew Ho

Presentation

Pre-op CXR. No chest symptoms.

Patient Data

Age: 55
Gender: Male

Initial exam

Modality: X-ray

Multiple symmetric, uniform sclerotic osseous foci of are present and are predominantly clustered around both shoulder joints and spine in this patient with known osteopoikilosis.  No aggressive or concerning osseous lesions are evident.

Six years later

Modality: X-ray

Multiple symmetric, uniform sclerotic osseous foci are again identified in a similar distribution and location as seen in the prior x-ray examination.  This demonstrates stability of these lesions.

Modality: CT

Innumerable uniform punctate sclerotic foci are seen distributed throughout the appendicular and axial skeleton.  There are no aggressive or concerning osseous lesions.

Case Discussion

Osteopoikilosis is a rare, benign, asymptomatic and often incidental bone dysplasia.  It has an autosomal dominant inheritance.  Occasionally it can mistaken for osteoblastic metastases.  However, osteoblastic metastases are often non-uniform sclerotic foci.  Bone scans in osteopoikilosis are also normal which would further differentiate it from osteoblastic metastases.

Osteopoikilosis often favors the appendicular skeleton and rarely involves the ribs, clavicles and spine.1  This case is unique in that these sclerotic foci are seen in both the appendicular and axial skeleton.

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Case Information

rID: 44407
Case created: 20th Apr 2016
Last edited: 10th Nov 2016
Inclusion in quiz mode: Included

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