Orthopedics - Oleksa A.P. 2006

Pathophysiology of Joints
Developmental Defects and Congenital Skeletal Anomalies
Osteopoikilosis

Osteopoikilosis was first described in 1905 by A. Stieda and subsequently by Albers-Schönberg; the name is derived from the Greek word "poikilos," meaning spotted. This condition is exceedingly rare and is typically reported as isolated case studies.

The core pathology involves the presence of small, round and oval dense sclerotic foci (ranging from 2 to 10 mm in size) throughout all the BONES OF THE Skeleton. These are detected on radiographs in individuals of any age, and even in infants (Fig. 51).

There are instances of familial Inheritance of the disease, as described by Melnick (1959), who observed osteopoikilosis across four generations, with the youngest affected individual being 4 years old and the oldest 74 years old.

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Fig. 51. Osteopoikilosis of the hands in a 37-year-old woman (Reinberg, S.A., 1964).

These sclerotic foci are discovered incidentally, most frequently in the cancellous bones of the hand, less commonly in the epiphyses of long bones, and are never found in the diaphyses. Radiographs clearly reveal small, punctate opacities that resemble splatters within the areas of the bone's spongy Structure. Occasionally, osteopoikilosis manifests not as small sclerotic spots, but as larger, solitary oval-shaped condensations oriented along the long axis of the bone. Such changes justify the term "osteopoikilosis," meaning spotted osteopathy. The bones retain their anatomical shape and normal growth, and ossification centers appear in a timely manner.

Histological examination by Schmorl indicates that these islands of sclerosis lack The structure of a compact bone layer, attributing them to an accumulation of a dense, compacted trabecular network of cancellous bone (Reinberg, S.A., 1964).

Clinically, osteopoikilosis is completely asymptomatic; the bone changes cause no discomfort to the patient. Laboratory tests reveal no deviations from normal values. The literature describes no cases of malignant transformation or other complications. This condition is an incidental radiological finding and requires no Treatment.