Incidental Diagnosis of Osteopoikilosis Using Plain Radiography in a Resource-Limited Tier 2 City: A Case Report and...

Osteopoikilosis is a rare, benign condition affecting bone development, characterized by many small areas of dense bone (enostoses) that are usually found unexpectedly during X-rays. Because its appearance on X-ray can resemble cancer spread to the bone (osteoblastic metastases), diagnosis can be difficult, particularly in areas where more sophisticated and expensive scans are not easily available. We present the case of a 26-year-old woman from an economically constrained background, with mild knee joint pain, who was diagnosed using standard X-rays alone. The typical pattern on the X-ray allowed a confident diagnosis of osteopoikilosis and ruled out more serious illnesses. This highlights the value of recognizing the specific features seen on imaging to prevent unnecessary tests, costs, and anxiety for the patient. A review of published studies is also included to emphasize how to make a diagnosis when resources are limited.