Hyperostotic and osteosclerotic changes of the tarsal navicular, associated with pustulosis palmaris and plantaris.
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Adult↗
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Results for “OSTEOSCLEROSIS”
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Vanishing osteosclerotic lesion of the humeral head.
We report on the spontaneous disappearance of a dense round lesion from within the greater tuberosity of the humerus. The patient was treated with oral non-steroidal anti-inflammatory agents for symptoms of subacromial bursitis. Symptoms resolved in 10 days and the lesion had vanished when radiographed 3 months later. We surmise the lesion to represent intraosseous crystal deposition.
Calcinosis↗
Regional bone changes in deep soft tissue hemangiomas: radiographic and MR features.
OBJECTIVE: To evaluate changes in bone adjacent to deep soft tissue hemangiomas of the extremities. DESIGN AND PATIENTS: We retrospectively reviewed the plain films of 115 patients with histologically proven deep soft tissue hemangiomas of the extremities. The length and pattern of the bone changes were analyzed and correlated with the MRI examination (n = 55) and surgical findings. RESULTS: Plain film studies demonstrated reactive bone changes adjacent to the deep soft tissue hemangiomas in 24 (21%) patients and phleboliths in 23 (20%) patients. The results of plain film analysis revealed a wide spectrum of regional bone changes adjacent to the hemangiomas, including periosteal reactions (16%), regional osteopenia (1%), cortical erosion (3%), bony overgrowth (3%), coarsening of the trabeculae (5%), and a combination of the above changes (4%). The length of the reactive changes corresponded approximately to the size of the hemangioma in 70% and was longer than the largest dimension of the hemangioma in 30%. Of the 55 patients studied with MRI, 39 (71%) patients had normal bones and 16 (29%) had bone changes. CONCLUSION: Deep soft tissue hemangiomas may cause changes in adjacent bones. Familiarity with the pattern of reactive bone changes may help to avoid misdiagnosis.
Adolescent↗
Condensing osteitis of the clavicle in a man.
Condensing osteitis of the clavicle is a rare, benign, usually painful condition leading to sclerosis of the medial end of the clavicle. In the English language literature, this has only been reported in women since its original description by Brower et al. in 1974 [1]. We report a clavicular lesion occurring in a man that is clinically, radiographically, and histologically identical to described cases of condensing osteitis.
Adult↗
Sclerotic lesions of the cervical spine in sarcoidosis.
Sarcoidosis is a common multisystem disorder characterized by noncaseating epithelial granulomata, with osseous involvement typically seen in 5% of patients. While the lace-like or cystic pattern frequently seen in radiographs of the phalanges is well appreciated, sclerotic lesions of the spine are uncommon. We review a case of sarcoidosis of the cervical spine with sclerotic changes that mimicked blastic metastatic disease.
Adult↗
Epithelioid hemangioma of bone.
Although no specific radiographic appearance has emerged to date for the epithelioid subtype of hemangioma, these lesions most typically exhibit well-defined osteolysis. Other relatively common features include surrounding sclerosis, cortical expansion and cortical destruction. We present a case of epithelioid hemangioma of the spine with an unusual radiological appearance which to our knowledge has not previously been reported: diffuse sclerosis of the involved vertebral body. The diffuse sclerosis seen in this case resembles the osteosclerotic process seen not only in benign entities such as subacute and chronic osteomyelitis, but also in malignant lesions such as osteoblastic metastatic disease and lymphoma.
Adult↗
Reversible sclerotic changes of lumbar spine and femur due to long-term oral isotretinoin therapy.
We present a rare case of retinoid-induced sclerotic changes of lumbar spine and femur demonstrated by dual energy x-ray absorptiometrie (DEXA). The patient had flowing ossification along thoracic spine resembling diffuse idiopathic skeletal hyperostosis (DISH), but there was no ligament calcification in the lumbar spine or pelvis. After discontinuation of the treatment, gradual decline of bone mineral density at lumbar and femoral sites was detected with serial DEXA measurements. To the best of our knowledge, although various abnormalities of bone due to retinoids have been described before, reversible sclerotic changes have not been reported.
Absorptiometry, Photon↗
Cystic angiomatosis with splenic involvement: unusual MRI findings.
Cystic angiomatosis is a rare disorder with a poor prognosis. We describe a case of a 33-year-old woman who presented with longstanding bone pain, hemolytic anemia, and an enlarged spleen. Radiologically, multiple osseous lesions with a mixed pattern of lytic and sclerotic areas were seen within the shoulders, spine, and pelvis. On CT and MRI of the abdomen, the spleen was markedly enlarged, with internal hyperdense foci on non-contrast CT scan, corresponding to low signal intensity areas on all MR pulse sequences. After administration of contrast, a mottled enhancement pattern throughout the entire spleen was seen both on CT and MRI. Cystic angiomatosis was proven by histological analysis of a biopsy specimen of an involved vertebra and histopathological examination of the spleen after subsequent splenectomy. This is the first report of a patient with disseminated cystic angiomatosis with splenic involvement in which the MRI features differ from the previous reports. Instead of the usual pattern consisting of multiple well-defined cystic lesions, a diffuse involvement replacing the entire spleen, with heterogeneous signal intensities on T2-weighted images and heterogeneous enhancement pattern, was seen in our patient.
Adult↗
Magnetic resonance imaging findings of osteoid osteoma of the proximal femur.
Osteoid osteoma (OO) is a benign bone tumor whose main radiological finding is nidus. OO of the proximal femur can also result in non-specific findings such as hip joint effusion, perinidal bone marrow edema and soft tissue mass. Since the nidus may be difficult to identify with MR, these non-specific findings can lead to erroneous diagnosis. Therefore, MR imaging technique should be optimized in order to identify nidus. Since MR imaging has assumed increasing importance in the evaluation of disorders of the hip, radiologists must be aware of the spectrum of findings of OO of the proximal femur. The aim of this pictorial review is to show the MR imaging findings of intra-articular and extra-articular OO of the proximal femur.
Bone Marrow↗
Imaging features of intraosseous ganglia: a report of 45 cases.
The aim of this study is to report the spectrum of imaging findings of intraosseous ganglia (IG) with particular emphasis on the radiographic and magnetic resonance (MR) features. Forty-five patients with a final diagnosis of IG were referred to a specialist orthopaedic oncology service with the presumptive diagnosis of either a primary or secondary bone tumour. The diagnosis was established by histology in 25 cases. In the remainder, the imaging features were considered characteristic and the lesion was stable on follow-up radiographic examination. Radiographs were available for retrospective review in all cases and MR imaging in 29. There was a minor male preponderance with a wide adult age range. Three quarters were found in relation to the weight-bearing long bones of the lower limb, particularly round the knee. On radiographs all were juxta-articular and osteolytic; 74% were eccentric in location, 80% had a sclerotic endosteal margin and 60% of cases showed a degree of trabeculation. Periosteal new bone formation and matrix mineralization were not present. Of the 29 cases that underwent MR imaging, 66% were multiloculated. On T1-weighted images the IG contents were isointense or mildly hypointense in 90% cases. Forty-one per cent of the cases showed a slightly hyperintense rim lining that enhanced with a gadolinium chelate. Thirty-eight per cent were associated with soft tissue extension and 17% with a defect of the adjacent articular cortex. Fifty-five per cent showed surrounding marrow oedema on T2-weighted or STIR images and two cases (7%) a fluid-fluid level prior to any surgical intervention. The authors contend that it is semantics to differentiate between an IG and a degenerate subchondral cyst as, while the initial pathogenesis may vary, the histological endpoint is identical, as are the imaging features apart from the degree of associated degenerative joint disease. IGs, particularly when large, may be mistaken for a bone tumour. Correlation of the typical radiographic and MR imaging features will indicate the correct diagnosis and obviate the need for biopsy.
Adult↗
The lucent rim: a radiographic and computed tomography sign of Paget's disease of the skull.
In seven of eight patients with osteoporosis circumscripta of the cranial vault, the pagetic bone lacunae were separated from the normal bone by a lucent rim visible on conventional radiographs and computed tomography scans. The contour of the rim was sharp on the side of the healthy surrounding bone and hazy on the side of the defect. To our knowledge, this sign has been reported in one single previous article dealing with two pagetic patients with the bisphosphonate escape phenomenon.
Adult↗
SKIBO diseases: a concept to avoid bloody diagnostic procedures in ambiguous skeletal lesions.
In cases with an "atypical" radiologic pattern-osteolytic as well as osteosclerotic or mixed - the radiologist should pay attention to the patient's skin. There he will often find specific changes that are the key to a correct interpretation of the radiologic abnormalities. In such cases the synopsis is of more value in differential diagnosis than more or less unspecific histologic findings. Entities with a non-arbitrary conjunction of changes of the skin and bones we call SKIBO diseases. Some of them have a high potential for mimicking malignant bone lesions, often with the consequence of unnecessary biopsies. In this article we present the typical dermatologic and radiologic signs and symptoms of neurofibromatosis, sarcoidosis and pustulotic arteroosteitis (PAO) with special focus on such skeletal lesions that may mimic malignancy.
Bone Neoplasms↗
Erdheim-Chester disease: a case report and literature overview.
Erdheim-Chester (EC) disease belongs to the group of lipoid granulomatosis. Symmetric sclerosis of the meta- and diaphysis of long tubular bones are pathognomonic radiologic changes. Additionally, other skeletal segments can be affected. Extraskeletal manifestations can occur in almost all organs; lungs, pericardium, retroperitoneum, skin, and orbita play particularly important roles. The last case of 38 cases of Erdheim-Chester disease with an extraordinary mediastinal and perirenal involvement is described. For the second time following the initial description by Chester, an axial skeletal pattern of eburnated vertebra is shown.
Aged↗
Experimental study of bone-implant contact with a parabolic acetabular component (Hofer-Imhof).
Incomplete bone contact with threaded acetabular components is usually attributable to the tapered thread design and sclerotic bone, and might be the reason for early loosening. The self-tapping flat threads of the Hofer-Imhof cup allow accurate insertion without incarceration, even in sclerotic bone. To demonstrate the effectiveness of this threaded cup design based on digitized measurements of bone contact area, six Hofer-Imhof cups were implanted into three human cadavers. The bone contact area at the threads was digitally analyzed on cadaver-explanted cups cut into horizontal and coronal sections. In cups fixed with ideal form fit, bone contact was 31.6% (range 8-55%) at the threads and 28.5% (range 0-49%) between the threads on average. In cups with incomplete bone contact secondary to insufficient reaming, the bone contact area averaged 27.4% (range 10-44%) at the threads. In sclerotic bone, the highest bone contact at the threads was 69%. The threads were the first part of the cup to achieve primary bone contact. Factors contributing to poor contact were incomplete reaming, sections which passed through the incisura of the acetabulum, and incomplete contact with the medial aspect of the acetabulum. The aim was to achieve complete bone contact. Because of the higher contact areas observed in sclerotic bone, some sclerotic bone should remain after reaming.
Acetabulum↗
Osteopathia striata with cranial sclerosis and hearing loss.
Osteopathia striata is a manifestation of several bone dysplasias. In association with cranial sclerosis, it represents a separate entity that is not limited to the bones, but may also affect other structures, leading to an abnormal face, cleft palate, deafness, heart defects and vertebral anomalies. Neurological findings range from normal development to marked retardation with hydrocephalus, cranial nerve deficiencies and deafness. So far, only a few patients have been described in the literature, demonstrating autosomal dominant inheritance. Here, we report a spontaneous mutation of inheritance. The parents and three sisters of the affected child are healthy. In 78.6% of the reported cases with osteopathia striata and hearing loss, a conductive hearing loss was described. Surgical attempts to mobilize the middle-ear bones were unsuccessful because of swelling and augmented growth of the bones in the middle ears. Here the mobilization of the eardrum was not attempted because the middle ear cavities were epidermized. This is the second case in the literature in which a myringotomy was not done because the middle ear was completely epidermized. As a possible alternative, children with osteopathia striata and cranial sclerosis with hearing loss should be fitted with hearing aids because surgery of the middle ear probably will be difficult or perhaps not possible.
Abnormalities, Multiple↗
Metastatic carcinoma of presumed prostatic origin in cremated bones from the first century A.D.
A cremated pelvis dating from the first century A.D. showed evidence of osteosclerotic metastasis, presumably secondary to prostate carcinoma. The case demonstrates the importance of microradiography in palaeopathology as well as some of the structural changes seen in cremated bone.
Bone Neoplasms↗
Osteosclerotic metastases with severe hypocalcemia, parathyroid hormone resistance, anemia, and cardiac failure.
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Aged↗