with short stature. AP and lateral radiographs of the skull (above) and axial CT without contrast of the brain (below) shows diffusely sclerotic skull bones with a thickened diploic space and diastatis of the coronal and lambdoid and sagittal sutures.The diagnosis was pyknodysostosis.
Infant with a
newly diagnosed adrenal mass. AP radiographs of the humerus (above) and radius and ulna (below) show lesions involving the proximal humeral diaphysis, entire radial diaphysis and proximal ulna diaphysis all of which are lytic in appearance and having a wide zone of transition and associated faint periosteal reaction.The diagnosis was bone metastases from neuroblastoma.
myelopathy caused by ossification of ligamentum flavum of which fluorosis as an etiology factor. a, b. T1 and T2 weight MRI of thoracic spine showed continuous multi-level ossification of ligamentum flavum between T7–12. c. CT scan showed ossified ligamentum flavum, note that there was a thin gap between the ossified ligament and the lamina.
The causes of generalized increase in bone density in adult patients, also known as generalized or diffuse osteosclerosis, can be divided according to broad categories:
- hematological disorders
- neoplastic (more commonly multifocal than generalized)
- osteoblastic metastases: most commonly prostate and breasts
- lymphoma: infiltrative
- leukemia: infiltrative
- sclerosis of marrow-containing skeleton with patchy areas of radiolucency
- urticaria pigmentosa
- can have symptoms and signs of carcinoid syndrome
- idiopathic (more commonly multifocal than generalized)
- Paget disease: coarsened trabeculae, bony expansion and thickened cortex
- congenital: sclerosing bone dysplasias
- hepatitis C associated osteosclerosis (HCAO)
There are several mnemonics for dense bones.
- diffuse bony sclerosis (mnemonic)
- Morbus Paget
- Renale Osteodystrophie
- osteoblastische Knochenmetastasen
- Osteopathia striata
- Adenokarzinom der Prostata
- differential diagnosis of generalised increased bone density in adults
- sclerosing bony dysplasias
- ossäre Lymphominfiltration