Sickle cell disease related osteosclerosis
30 years old referred by GP with ongoing cough.
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Diffusely sclerotic bones (osteosclerosis) incidentally seen on PA chest radiograph performed for suspected lower respiratory tract infection. Also, multilevel H-shaped vertebrae are seen.
Osteosclerosis or diffuse increased bones density is caused by many underlying diseases including:
- congenital, e.g. osteopetrosis (usually associated with extensive nephrocalcinosis)
- haematological, e.g. myelofibrosis, mastocytosis (dermatographia is very characteristic for this entity) and sickle cell anaemia
- metabolic, e.g. secondary hyperparathyroidism (renal osteodystrophy)
- malignant, e.g. metastatic disease, most commonly from prostate or breast primary neoplasm
- toxic, e.g. fluorosis, vitamin D hypervitaminemia
In this case, sickle cell anaemia turned out to be a cause (H-shaped vertebrae helped to narrow the differential).