| disease | Osteoporosis |
Osteopoikilosis, also known as spotted bone or osteopathia condensens disseminata, is characterized by widespread dense spots on multiple bones throughout the body. It typically does not cause clinical symptoms and is often discovered incidentally during X-ray examinations for other reasons.
bubble_chart Epidemiology
Disease onset: It is a rare disease. The incidence is twice as high in males as in females, with the majority of cases occurring in adults.
The cause of the disease is unknown. It is a congenital developmental anomaly with a genetic and familial history. It is generally considered to be an autosomal dominant inheritance.
bubble_chart Pathological Changes
Within the cancellous bone, grayish-white, round or oval small bone fragments resembling bone tumors are visible to the naked eye, with irregular edges and no relation to the cortex or articular cartilage. Microscopically, these spots are composed of many relatively regularly arranged, thicker-than-normal trabeculae, varying in thickness, resembling the structure of cancellous bone. Most are parallel to the long axis of the long bone, gradually merging into the surrounding spongy bone without a clear boundary, while the rest of the bone structure remains normal.
bubble_chart Clinical Manifestations
No symptoms are produced, and 20% of patients complain of joint pain, especially in the sacrum, but it is unclear whether it is caused by the spots in the bones or is associated with wind-dampness pain. Sometimes, nodular tissue hyperplasia of the skin and a tendency to form keloids occur.
X-ray findings: Round or oval dense spots can be seen, affecting almost the entire body, particularly in the epiphyseal regions and metaphyses of long bones, but rarely in the diaphysis. The spots vary in size, with diameters ranging approximately from 2mm to 10mm, and their numbers differ. They are rare in the spine, ribs, and clavicle, and even rarer in the skull. The skeletal outline remains unchanged, epiphyseal development is unaffected, and joint spaces are normal. In adults, the spots generally show no significant changes, whereas in children, they may increase, disappear, or fuse.
The diagnosis is made entirely based on X-rays. On X-rays, it should be differentiated from the following diseases: melorheostosis, chondrodysplasia (Ollier's disease), metastatic carcinoma, etc.
bubble_chart Treatment Measures
Asymptomatic, no deformity, no treatment required.
The prognosis is good, with no impact on development or life expectancy. However, one case has been reported where osteopoikilosis developed fleshy tumor transformation.
