A rare benign disorder mimicking metastasis on radiographic examination: a case report of osteopoikilosis

Abstract

Osteopoikilosis (OPK) is a rare, autosomal dominant bone disorder, characterized by multiple, discrete round or ovoid radio densities scattered throughout the axial and appendicular skeleton. OPK is usually asymptomatic but rarely there may be slight articular pain and joint effusions. OPK is generally diagnosed incidentally on radiographic examinations and may mimic different bone pathologies, including bone metastases. Radionuclide bone scan has a critical role in distinguishing OPK from osteoblastic bone metastases. In this case report, we present a young man with right hip pain due to OPK, whose plain radiogram and computerized tomography findings thought cancer metastasis.

Fig. 1

Anteroposterior radiograph of the pelvis showing multiple, small, ovoid sclerotic lesions in both femoral heads, ileum and around the acetabulum of the pelvis, without narrowing the joint spaces

Fig. 2

Computed tomography image of the patient showing multiple round sclerotic nodular lesions at iliac wings and sacrum which are mimicking metastases

Fig. 3

Tc-99m bone scintigraphy image of the patient showing kidney fusion anomaly

Fig. 4

Anteroposterior radiograph of the hands demonstrating multiple sclerotic foci in the distal radius and ulna, carpal, metacarpal and proximal phalangeal bones

Fig. 5

Bilateral anteroposterior radiograph of the shoulder showing multiple radiodense sclerotic foci of the proximal humerus