Presentation
Pre-op CXR. No chest symptoms.
Patient Data
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.
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.
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.