Clinical features of ten cases of osteopoikilosis

Abstract

A retrospective study was carried out of the ten cases of osteopoikilosis seen at this Orthopedic Unit over a 15-year period in order to determine the reasons why patients seek consultation, preliminary diagnosis, and associated lesions. Eight patients consulted for problems not related to the locomotor apparatus, and diagnosis was by chance; the other two presented joint pain. The preliminary diagnosis was osteoblastic metastasis in five patients and osteopoikilosis in the other five. None of the patients displayed skin or visceral involvement, but three presented bone alterations. Definitive diagnosis was made by measurement of biochemical markers of bone remodeling, radiography of both hands, and bone scan. Bone biopsy was performed in one case. Although rare, the radiographic symptoms of osteopoikilosis are sufficiently specific to avoid false diagnoses, which may give rise to rigorous and expensive studies for other important disorders.

Osteopoikilosis: what does the rheumatologist must know about it?

“…Sites of predilection include phalanges (100%), carpal bones (97.4%), metacarpals (92.5%), foot phalanges (87.2%), metatarsals (84.4%), tarsal bones (84.6%), pelvis (74.4%), radius (66.7%), ulna (66.7%), sacrum (58.9%), humerus (28.2%), tibia (20.5%), and fibula (2.8%) [4]. The definitive radiologic diagnosis is made by radiography of both hands since in all OPK patients the metacarpal bones are affected [5]. Our patient presented lesions on phalanges, carpal and metacarpal bones, metatarsals and tarsal bones, pelvis, radius, ulna, humerus, femur, and scapula.…”

Osteopoikilosis: A case with osteopenia

“…Typically, patients are asymptomatic, although as many as 20% may have articular pain and effusion. Clinically osteopoikilosis must be distinguished from more severe dysplasias, such as tuberous sclerosis, mastocytosis and most importantly, osteoblastic metastatic lesions [5]. The cause and pathogenesis of this condition are not known.…”

Coexistence of osteopoikilosis with seronegative spondyloarthritis and Raynaud’s phenomenon: first case report with evaluation of the nailfold capillary bed and literature review

“…In the presence of only a few striae, the differential diagnosis involves melorheostosis. As far as osteoblastic metastasis is concerned, these are more frequently observed in the axial skeleton and are not uniform but are asymmetric, and vary in size with osseous destruction and positive scintigraphy findings; OPK has symmetric, regular oval or rounded lesions, localized predominantly around the joints (19)(20)(21)(22)(23)(24)(25). No therapy is required, except in particular cases in which either the patient complains of severe articular pain (for which analgesic drugs are indicated) or symptoms associated to other pathologies are presented.…”

“…In our case, no pain relief was obtained from non-steroidal anti-inflammatory drug treatment until we considered the associated pathology (spondyloarthrits) and modified the treatment regimen accordingly; remission of symptoms was then achieved. Occasionally, OPK may coexist with dermatological pathologies (scleroderma, dermatofibrosis lenticularis disseminata, keloid formation, plantar and palmar keratoma), heart or renal malformations, endocrine disorders, or skeletal diseases (exostosis, spinal stenosis, chondrosarcoma, osteosarcoma) (18)(19)(20)(21)26). OPK has also been described in association with rheumatoid arthritis, reactive arthritis, discoid lupus erythematosus, familial Mediterranean fever, psoriatic arthritis, or fibromyalgia (10-13).…”