Presentation
Punched wall with right hand. Re-presentation with atraumatic sudden onset shortness of breath.
Patient Data
Volar angulated fractures of the 4th-5th metacarpal necks. Bony islands in the distal radius/ulna, carpals, metacarpals and phalanxes.
Right sided pneumothorax that becomes more prominent on expiratory view. Bony islands in the humeral head and scapula.
Multiple enostoses in distal radius/ulna, carpals, metacarpals.
Case Discussion
Multiple x-rays demonstrate incidental findings of bony islands consistent with osteopoikilosis. The typical pattern of longitudinal alignment with the bone trabeculae is better appreciated in the proximal phalanxes and humeral head in these x-rays. In areas where there is less longitudinal organization of bone trabeculae, the islands take on a more spherical shape.
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