IS Case 323: Osteopoikilosis

A. R. Klekers, MD

Imaging Sciences URMC 2009
Publication Date: 2009-09-14

History

Patient is a 22-year-old female with foot injury.

Findings

Multiple small sclerotic foci consistent with bone islands throughout the left foot.

Diagnosis

Osteopoikilosis

Discussion

Osteopoikilosis is best defined as hereditary disorder where there are circular densities within the bones. These patients are asymptomatic. Pathologically these findings represent compact bone islands. Typically lesions are 2-10 mm. Lesions are diffusely distributed throughout long bones. Most common sites include the hands and feet. Typically the skull, ribs, and vertebrae are not affected. In some cases patients have connective tissue nevi. Lesions demonstrate no uptake of tracer on bone scans. These lesions should be differentiated from sclerotic metastases. In osteopoikilosis there is symmetrical distribution with more frequent involvement of the epiphysis and metaphysis of bones. The lesions are also of uniform size.

References

Resnick D, Niwayama G. Enostosis, hyperostosis and periostitis. IN: Resnick D, Niwayama G, Eds., Diagnosis of Bone and Joint Disorders. 2nd ed., Philadelphia: W.B. Saunders, 1988:4084-4088.