Osteopoikilosis or Spotted Bone

Osteopoikilosis is a  benign, autosomal dominant skeletal dysplasia that manifests radiographically as multiple bone islands which are especially seen near the joints, epiphyses, metaphyses of long and short tubular bones. The condition is also known as the spotted bone.

The islands are also seen in in the pelvis and scapulae. The distribution is typically bilateral and symmetrical.

They are rarely seen in the ribs, clavicles, spine, and skull.

Males and females are equally affected.

It is usually incidentally found on skeletal x rays. Its importance is predominantly incorrect diagnosis so that it is not mistaken for pathology.

The bone islands of osteopoikilosis develop during childhood. They do not regress and therefore are seen in all age groups. There is no gender predilection.

Osteopoikilosis has been associated with

• Dermatofibrosis lenticularis disseminata
• Scleroderma
• Syndactyly
• Dwarfism
• Endocrine abnormalities
• Melorheostosis
• Cleft palate

Most patients have no other findings.

Presentation

The condition is by and large asymptomatic. It is a radiological finding. Some association with joint pains have been reported.

Laboratory tests are normal.

Xrays reveal multiple bony islands which are round or ovoid, intramedullary and sclerotic.

Imaging of Osteopoikilosis

On x-ray and CT, bone islands of osteopoikilosis are typically clustered around joints and align themselves parallel to surrounding trabeculae, most being found in the appendicular skeleton and pelvis. The axial skeleton is largely spared.

On MRI, each lesion is small and dark on both T1 and T2 weighted images.

Treatment

Generall,y no treatment is required.