Osteopoikilosis: a case with osteopenia.

Osteopoikilosis is a benign osteosclerotic dysplasia of unknown origin, which is an inherited autosomal disorder. It is usually asymptomatic and may only be recognized on radiological examination. We report a 20-year-old man who suffers from back and shoulder pain during the routine physical examinations performed prior to the military recruitment. Numerous symmetric, small, ovoid and circular sclerotic bone lesions were found on the X-rays of the spine and shoulder. Dual energy X-ray absorptiometry (DXA) examination revealed osteopenia. In conclusion, typical radiographic examination of osteopoikilosis is usually diagnostic. However, it may sometimes be difficult to rule out the other diseases like osteoblastic metastatic lesions as it is an uncommon disease. Physicians should be aware of possible coexisiting osteopenia or osteoporosis as reported in our case.