99mTc-pyrophosphate bone imaging in osteopoikilosis, osteopathia striata
, and melorheostosis.
The differential diagnosis of osteopoikilosis includes: sclerotic bone metastasis (especially from prostate cancer) , osteopathia striata, osteoporosis, melorheostosis, tuberous sclerosis, hyperparathyroidism [27, 28], mastocytosis, enostosis, osteoma .
The combination between osteopoikilosis, melorheostosis and osteopathia striata (type 1) is the most frequent form of overlap syndrome [13, 26].
Osteopathia striata is another rare bone dysplasia, characterized by long hyperdense striations mainly in the metaphyses of long bones and pelvis.
Osteopathia striata with cranial sclerosis owing to WTX gene defect.
It may occur in association with other types of sclerosing bone dysplasias such as osteopoikilosis and osteopathia striata (4) and with tumor-forming disease such as tuberous sclerosis and neurofibromatosis.
Osteomyelitis, osteopetrosis, osteopoikilosis, and osteopathia striata should all be considered in the differential diagnosis, (9, 10) but the most important differential diagnosis of melorheostosis is bone tumors producing dense bone, primarily the various types of osteosarcoma.
Increased bone density without modifcation of bone shape Osteopetrosis precocious type Generalised AR delayed type Type 1 uniform AD intermediate type Type 2 endobones with renal tubular Generalised AR AR acidosis Similar other types Axial osteosclerosis osteomesopyknosis Focal sclerosis AD AR with bamboo hair in vertebrae/pelvis Pycnodysostosis Generalised AR Osteosclerosis Cortical AD Stanesu type thickening of long bones, defcient facial sinus development Osteopathia striata
Radiodense SP XLD isolated with striations on all cranial sclerosis bones with cranial sclerosis Sponastrime Striated AR dysplasia metaphysis Melorheostosis Flowing SP hyperostosis Osteopoikilosis Radiodense spots AD Mixed sclerosing Combined pattern SP bone dysplasia 2.
Osteosarcoma arising in a femur with melorheostosis and osteopathia striata
Radiologically, the differential diagnosis of OPK includes osteopathia striata
, melorheostosis, tuberous sclerosis, sclerotic bone metastases, and osteoma (which may have similar clinical pictures but for which medical and orthopedic treatment may be necessary).