Symptoms and clinical course vary in ECD, depending on the sites of involvement, but they usually include juxta-articular pain in the legs due to multiple diaphyseal osteosclerotic
lesions in the long bones that are almost always bilateral and symmetric.
Eumycotic and actinomycotic mycetoma are characterized by multiple punched out lytic lesions and both osteolytic and osteosclerotic
lesions in bones respectively.
Whole body bone scan [Figure 1]c and chest computer tomography (CT), [Figure 1]d identified a focal area with increased technetium-99m diphosphonate scintigram uptake over the right scapula compatible with right scapular mass and a large cauliflower-like osteosclerotic
lesion exophytic from the inner area of the right scapular body.
X-Ray made on lumbar spine, hands, feet and pelvis showed: multiple osteosclerotic
oval-round lesions with a maximum diameter of 10 mm, without osteolysis, with a benign character and with a periarticular localization at the level of the fist, metacarpophalangeal joints, proximal interphalangeal joints, coxofemoral joints, peritarsal, metatarsophalangeal and interphalangeal joints.
We made a review of the radiologic findings: the lesion was intraosseous, the osteolysis was of geographic type, there was no periosteal reaction, the cortex was intact, and there was a slight osteosclerotic
rim at one site--all the features characteristic for benign lesion.
Unlike most of the other osteosclerotic
dysplasias, melorheostosis is not believed to be a genetic disorder.
Few cavities, scattered on the whole bone diaphysis with osteosclerotic
septum, were excised by forming the single cavity; it resulted with restoration of the anatomic structure of intramedullary canal on the whole length.
The syndrome has a number of characteristic clinical and radiographic signs that differentiate it from other osteosclerotic
Diseases include chondrosarcomas, metastatic carcinoma to bone, bone cysts, lipomas, achondroplasia, the Ehlers-Danos syndromes, Marfan syndrome, osteosclerotic
disorders, Hunter's disease, clinical gout and hyperuricemia, and hypoparathyroidism.
82%) patients which included genu varum in 9, genu valgum in 2, wind swept deformity in 1, bilateral coxa vara in 1, protrusio acetabulae in 1, fractures in 5, pseudofractures in 3, and lytic bone lesions with osteosclerotic
margin over acetabular roof in 1 patient (Fig.
The mass had a lytic nature with well defined osteosclerotic
boundaries and facet joints were normal (Figure 1).
Reactive sclerosis is often seen with lymphoma, metastatic carcinoma, osteosclerotic
myeloma, Ewing's sarcoma, and osteomyelitis.