Background: Osteopoikilosis (OPK) is a rare inherited condition of the bones,
transmitted as an autosomal dominant trait characterized by numerous
hyperostotic areas that tend to localize in periarticular osseous regions. It
is usually asymptomatic and is often diagnosed incidentally during x-rays made
by other reasons. We present a case of 34-year-old man suffering from
polyarthralgia and low back pain. Case presentation: A 34-year-old male
patient, smoking 40 packs yearly and alcoholic was referred to our department
of rheumatology, complaining of polyarthralgia which started 3 years ago and
involving large and small joints. He reported the presence of pelvic pain
mostly located at both hip joints and in the two ankles. On radiologic
examination, numerous, symmetric, well defined, sclerotic lesions were
identified on shoulder, wrist, ankles, pelvis, and on spine. The size of the lesions varied from 2 to 9
millimeters. These spots were located on spongious bone tissue, and in the
inner bone cortex located bilaterally in the epiphyses and metaphyses. We
concluded the diagnosis of OPK. His mother was found to have the same lesions
without any symptoms. Conclusion: OPK may be an isolated finding or associated with
other pathologies, e.g. skin manifestations, rheumatic and/or skeletal
disorders. The main differential diagnosis is osteoblastic metastasis