Osteopoikilosis

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Osteopoikilosis
Osteopoikilie Haende.jpg
Osteopoikilosis on an X-ray of the hands
Specialty Medical genetics   OOjs UI icon edit-ltr-progressive.svg

Osteopoikilosis is a benign, autosomal dominant sclerosing dysplasia of bone characterized by the presence of numerous bone islands in the skeleton. [1]

Contents

Presentation

The radiographic appearance of osteopoikilosis on an X-ray is characterized by a pattern of numerous white densities of similar size spread throughout all the bones. This is a systemic condition. It must be differentiated from blastic metastasis, which can also present radiographically as white densities interspersed throughout bone. Blastic metastasis tends to present with larger and more irregular densities in less of a uniform pattern. Another differentiating factor is age, with blastic metastasis mostly affecting older people, and osteopoikilosis being found in people 20 years of age and younger.

The distribution is variable, though it does not tend to affect the ribs, spine, or skull. [2]

Cause

Epidemiology

Men and women are affected in equal number, [3] reflecting the fact that osteopoikilosis attacks indiscriminately. Additionally, the disease is often associated with melorheostosis, [4] despite the apparent lack of correlation between melorheostosis and genetic heritability.[ citation needed ] It has been tied to LEMD3. [5] Buschke–Ollendorff syndrome is a similar condition, [6] which is also associated with LEMD3. [7]

See also

Related Research Articles

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Tricho–dento–osseous syndrome (TDO) is a rare, systemic, autosomal dominant genetic disorder that causes defects in hair, teeth, and bones respectively. This disease is present at birth. TDO has been shown to occur in areas of close geographic proximity and within families; most recent documented cases are in Virginia, Tennessee, and North Carolina. The cause of this disease is a mutation in the DLX3 gene, which controls hair follicle differentiation and induction of bone formation. One-hundred percent of patients with TDO suffer from two co-existing conditions called enamel hypoplasia and taurodontism in which the abnormal growth patterns of the teeth result in severe external and internal defects. The hair defects are characterized as being rough, course, with profuse shedding. Hair is curly and kinky at infancy but later straightens. Dental defects are characterized by dark-yellow/brownish colored teeth, thin and/or possibly pitted enamel, that is malformed. The teeth can also look normal in color, but also have a physical impression of extreme fragility and thinness in appearance. Additionally, severe underbites where the top and bottom teeth fail to correctly align may be present; it is common for the affected individual to have a larger, more pronounced lower jaw and longer bones. The physical deformities that TDO causes become more noticeable with age, and emotional support for the family as well as the affected individual is frequently recommended. Adequate treatment for TDO is a team based approach, mostly involving physical therapists, dentists, and oromaxillofacial surgeons. Genetic counseling is also recommended.

Malignant infantile osteopetrosis, is a rare osteosclerosing type of skeletal dysplasia that typically presents in infancy and is characterized by a unique radiographic appearance of generalized hyperostosis - excessive growth of bone.

References

  1. Bull M, Calderbank P, Ramachandran N (2007). "A cause for concern? Osteopoikilosis found incidentally in the emergency department: a case report". Emerg Med J. 24 (5): e29. doi:10.1136/emj.2006.045765. PMC   2658513 . PMID   17452689.
  2. Balan, Nisha Sharma, Anu (2008). Get through FRCR part 2B : rapid reporting of plain radiographs. London: Royal Society of Medicine. ISBN   978-1853157547.
  3. Serdaroğlu M, Capkin E, Uçüncü F, Tosun M (2007). "Case report of a patient with osteopoikilosis". Rheumatol. Int. 27 (7): 683–6. doi:10.1007/s00296-006-0262-9. PMID   17106662.
  4. Nevin NC, Thomas PS, Davis RI, Cowie GH (1999). "Melorheostosis in a family with autosomal dominant osteopoikilosis". Am. J. Med. Genet. 82 (5): 409–14. doi:10.1002/(SICI)1096-8628(19990219)82:5<409::AID-AJMG10>3.0.CO;2-2. PMID   10069713.
  5. Hellemans J, Preobrazhenska O, Willaert A, et al. (2004). "Loss-of-function mutations in LEMD3 result in osteopoikilosis, Buschke–Ollendorff syndrome and melorheostosis". Nat. Genet. 36 (11): 1213–8. doi: 10.1038/ng1453 . PMID   15489854.
  6. synd/1803 at Who Named It?
  7. Mumm S, Wenkert D, Zhang X, McAlister WH, Mier RJ, Whyte MP (2007). "Deactivating germline mutations in LEMD3 cause osteopoikilosis and Buschke–Ollendorff syndrome, but not sporadic melorheostosis". J. Bone Miner. Res. 22 (2): 243–50. doi:10.1359/jbmr.061102. PMID   17087626.
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