[Pleural empyema revealing osteopoikilosis]
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L Boussoffara1, L Fekih, S Fenniche
1Service de pneumologie Ibn Nafiss. Hôpital Abderrahmen Mami Ariana. Tunisie.
Introduction:
Osteopoikilosis is a rare, inherited and usually asymptomatic sclerosing bone dysplasia of unknown etiology which predominantly involves the appendicular and rarely the axial skeleton.
Case Report:
We report the case of a 24 year old man who was hospitalized for pleural empyema and treated with antibiotics for six weeks in addition to pleural evacuation and physiotherapy. The diagnosis of osteopoikilosis associated with the pleural empyema was made on the radiological findings. In fact the chest X-Ray showed spherical areas of increased bone density in both humeral epiphyses. In order to explore these bone abnormalities further investigations were performed, including red and white blood cell counts, sedimentation rate and protein electrophoresis. There were no biological abnormalities. Radiography of the whole skeleton showed disseminated sclerotic lesions in the pelvis and the metacarpal and carpal bones of both hands. A neoplastic aetiology was excluded. In the light of these investigations, the diagnosis of osteopoikilosis was established.
Conclusion:
Widespread osteopoikilosis can be revealed on chest radiography.
Insights
Osteopoikilosis, a rare bone disorder, can be incidentally discovered through chest X-rays, even when presenting with conditions like pleural empyema. This case highlights the importance of radiological findings in diagnosing this inherited bone dysplasia.
Area of Science:
- Medical Imaging
- Skeletal Dysplasias
- Radiology
Background:
- Osteopoikilosis is a rare, inherited sclerosing bone dysplasia.
- It is typically asymptomatic and affects the appendicular skeleton.
- The etiology of osteopoikilosis remains largely unknown.
Purpose of the Study:
- To report a case of osteopoikilosis diagnosed in a patient presenting with pleural empyema.
- To illustrate the diagnostic utility of radiography in identifying osteopoikilosis.
- To highlight the potential for incidental findings of bone disorders on chest imaging.
Main Methods:
- Case report of a 24-year-old male hospitalized for pleural empyema.
- Diagnosis of osteopoikilosis based on radiological findings from chest X-ray and whole-skeleton radiography.
- Exclusion of neoplastic etiology through laboratory tests and imaging.
Main Results:
- Chest X-ray revealed spherical areas of increased bone density in humeral epiphyses.
- Whole-skeleton radiography showed disseminated sclerotic lesions in the pelvis and hands.
- No biological abnormalities were detected, supporting a diagnosis of osteopoikilosis.
Conclusions:
- Widespread osteopoikilosis can be incidentally detected on chest radiography.
- Radiological findings are crucial for diagnosing osteopoikilosis, even in the context of other medical conditions.
- This case underscores the importance of thorough radiological assessment.
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