Osteosclerosis in leprosy

The literature contains little reference to the phenomenon of osteosclerosis in leprosy. The aim of the authors' investigations was to determine: a) the incidence of osteosclerosis as part of the radiographic picture in the distal extremities of the limbs; b) the pathological substratum; c) the possible clinical significance. The research was carried out on 233 leprosy patients at the Colonia Hanseniana di Gioia del Colle (Bari). The authors examined 260 radiographs of the hands and 1310 radiographs of the feet. A number of biopsy samples of bone were taken from four patients and examined by means of microradiography using ultraviolet fluorescent light and also by historadiography. The basic radiographic features indicative of osteosclerosis were: a) reactive osteosclerosis; b) sclerosing periostosis; c) massive osteosclerosis. The authors observed a preponderance of osteosclerosis in the bones of the first digital ray, both in the phalanges and metatarsals or metacarpals. The sesamoid bones were affected more commonly in those of the first digit than those of the fifth. The radiographic findings were confirmed microscopically. It is difficult to assess the possible clinical significance because of the transient nature of the osteosclerosis in the evolution of the lepromatous lesions with time.