Fragile osteosclerosis
Introduction
Introduction to fragile osteosclerosis Osteoporosis (osteopoikilosis) is also known as bone spot disease, disseminated agglutinous bone disease (osteopathiacondensensdisseminata) and spotted bone (spottedbone). Dense spots widely spread on most of the body's bones generally do not produce clinical symptoms, and most of them are accidentally discovered by X-ray examination for other reasons. The disease is best found in the cancellous bone of the tubular bone, the metaphysis of the metaphysis, and also in some flat bones and irregular bone. According to the pathological observation, there are a plurality of gray-white round or elliptical dense small bones in the cancellous bone. basic knowledge The proportion of sickness: 0.01%-0.05% Susceptible people: no specific people Mode of infection: non-infectious Complications: osteogenesis imperfecta
Cause
Vulnerable osteosclerosis
The cause is unknown. It is a congenital dysplasia with inheritance and family history. It is generally considered to be an autosomal dominant inheritance. It may be a familial morbidity or a sporadic case. So far, it has been reported as a sporadic report. less.
Prevention
Vulnerable osteosclerosis prevention
There are no effective preventive measures for this disease.
Complication
Vulnerable osteosclerosis complications Complications osteogenesis imperfecta
The disease has no clinical symptoms. If it occurs in childhood, its lesions may increase with age, increase and increase in density; a few children's lesions can disappear on their own, and the lesions tend to be stable after adulthood. Some patients Can be combined with rheumatic pain, wax tear-like bone disease embolism.
Symptom
Vulnerable osteosclerosis symptoms common symptoms bone spots limb striated hypertrophy
The bone spot is located in the sponge bone. It is not related to the cortical bone and articular cartilage. The bone contour is normal. It is scattered in multiple localized bone sclerosis area. It can be seen that the hardened area is composed of tightly packed small platelets with irregular edges. Like osteoma, this disease does not occur inflammation, necrotic pathological fractures and malignant transformation, clinically without any symptoms, often found because of other causes of the diagnosis, the disease occurs in the hands, feet, pelvis, long bones and bones, sternum, Ribs, clavicle, long bones are less common, and there is no change in the skull and spine.
Examine
Vulnerability of bone sclerosis
The disease occurs in the cancellous bone of long and short tubular bone and in the scapula, pelvis, carpal bone, foot bone and other flat bones and irregular bones, rarely occur in the backbone, in the spine, ribs, clavicle, skull is extremely rare .
1. X-ray examination is the main basis for the discovery and diagnosis of the disease. The X-ray lesions are diffuse and multi-round, round or fused into strips and clumps, located in the cancellous bone, walking and bone. The long axis is consistent, the bilateral sides are basically symmetrical, and the size is between several millimeters and 2 cm; the closer to the joint lesion, the denser the density is; the density of most lesions is high, the edge density is low, and the density of a few lesions is low, but The edges are clear; the lesion does not invade the periosteum and articular cartilage, and the joint space is clear.
2, CT: can more clearly show the location, size, shape and relationship with the cortex, and can also find small lesions difficult to display on the X-ray film, CT is characterized by the lesion located in the cancellous bone, and small bone The beam distribution is consistent, a few are located in the cortical bone or under the cortical bone, and the thickening density of the cortical bone in the corresponding part is increased, mostly round or oval high-density nodules, the boundary is clear, and some are cluster-like changes.
3, MR: manifested as uneven lesions scattered in the cancellous, round, round nodules and irregular strip-like abnormal signals, very low signal on T1WI and T2WI, clear boundaries, multiple lesions Aggregated into a "honeycomb", there is no abnormal signal in the surrounding soft tissue.
Diagnosis
Diagnosis and differentiation of fragile bone sclerosis
diagnosis
Diagnosis depends entirely on X-ray. It is different from the following diseases on the X-ray, limb striate hypertrophy, abnormal cartilage (Ollier disease), metastatic cancer.
Differential diagnosis
The X-ray manifestations of this disease are quite characteristic, and the clinical symptoms are obvious. The diagnosis is generally not difficult, but it needs to be differentiated from other dense diseases that occur at the metaphysis of the long bones:
(1) Osteogenic metastases: lesion size, shape, asymmetric distribution, mainly found in the central axis of the bone, usually does not involve the epiphysis, a cotton ball-like dense shadow with blurred edges.
(2) Abnormal development of punctate callus: a congenital type of multiple epiphyseal dysplasia, usually found in infants within 1 year of age, sometimes in infants or children, and lesions are limited to the epiphysis area, which may be accompanied by irregular metaphysis. The backbone is not tired, and the normal shape of the epiphysis disappears. The lesions are frequent, the spots are small and the density is high, and the lesions are symmetric. The lesions disappear with age.
(3) Osteoinfarction or decompression sickness: the lesions are more limited, usually in the long bone or medullary cavity, can be spotted or cord-like, osteonecrosis changes, common in adults, the latter has a history of deep water operation.
(4) Dry cartilage dysplasia (Jansen type): Spotted calcification is only found in the dry area. The lesions are symmetrical, the calcifications are small and irregular, and the metaphysis is enlarged and the edges are not complete.
(4) Wax oil bone disease: irregular long strips or patchy dense shadows, visible in the cortical bone, subperiosteal or extra-bone soft tissue, the lesions are not symmetrical.
(6) Streak bone disease: The lesions are often narrow and narrow, with dense stripes of different lengths. They are common in the metaphysis and can reach the backbone. Those with osteophytes are rare, and there is no obvious abnormality in bone morphology.
In addition, bone spot disease should be differentiated from mast cell disease and tuberous sclerosis.
