Ibtissam El Bqaq, Sarah Lembarki, Salma El Kadiri, Hassan Ennouali, Jamal El Fenni, Rachida Saouab
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 9
Date of Publication: 2026/09/27
Osteopoikilosis is a rare, benign sclerosing bone dysplasia characterised by multiple small foci of cortical (lamellar) bone within the medullary cavity, typically discovered incidentally on imaging. Although classically asymptomatic, it may occasionally be associated with non-specific musculoskeletal pain, and its radiological appearance can closely mimic osteoblastic bone metastases, creating a significant diagnostic challenge. We report the case of a 53-year-old woman with no significant past medical history who presented with diffuse bone pain. She had no cutaneous lesions suggestive of an associated connective tissue disorder. Computed tomography, performed as part of the diagnostic work-up, revealed innumerable well-defined sclerotic lesions of variable size distributed throughout the axial and appendicular skeleton. No conventional radiograph was available for comparison. Laboratory investigations were unremarkable. Given the diffuse nature of the findings and the absence of a baseline radiograph, a bone biopsy was performed to exclude a malignant sclerotic process; histopathological examination confirmed a benign lesion, consistent with osteopoikilosis. The patient was managed conservatively with clinical surveillance. This case underscores the importance of recognising the characteristic imaging pattern of osteopoikilosis to avoid unnecessary invasive investigations, while also illustrating that tissue confirmation may still be warranted when the diagnosis is made on cross-sectional imaging alone, without a corroborating radiograph.
Osteopoikilosis, Sclerosing bone dysplasia, Bone islands, Enostosis, LEMD3
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