Osteopoikilosis

There are multiple circular and ovoid sclerotic opacities involving the ischial and pubic bones as well as the hips.
These opacities appear to be parallel each other and to the long axis of the bone.
- These sclerotic areas may be more apparent on a detailed view.
Similar findings are present in the knees.
A periarticular distribution is evident.
The left shoulder (not shown) had similar findings.

Radiography is compatible with Osteopoikilosis.

You may wish to review some facts regarding this entity:

Osteopoikilosis is a benign, asymptomatic sclerosing dysplasis.
- Affects both M and F.
- May be seen at any age.
- Cutaneous lesions in 25%.
- Etiology unknown.
- Inherited and spontaneous cases occur.
Radiographically,
- Sclerotic circular or ovoid lesions symmetrically distributed in a periarticular location.
- Lesions can increase or decrease in size and number in serial radiographs or even disappear.
- Lesions do not have increased bone radiotracer uptake.
Microscopically, resembles bone island.
May be related to other sclerosing dysplasias including,
- Osteopathia striata.
- melorheostosis.
- focal sclerosis.
and when seen in combination with them, is termed "Mixed Sclerosing Bone Dystrophy."
DDx includes:
- Osteoblastic metastases.
- Mastocytosis.
- Tuberous Sclerosis.

Ref: Resnick, D., Bone and Joint Imaging, W.B. Saunders, Philadelphia, PA, 1989, pp. 1234-1239.