Learning objectives
The objectives are to present a case report on intramedullary osteosclerosis (IMOS) of an elderly patient with antalgic gait,
to summarize the basic features of IMOS,
to quote its characteristic imaging findings and to underline the utility of an exclusive diagnostic approach for the recognition of this disease.
Background
The term intramedullary osteosclerosis (IMOS) was first introduced by Abdul-Karim in 1988.
It is a rare nonhereditary ,idiopathic pathological condition characterized by asymmetrical osteosclerosis and endosteal new bone formation in the medullary cavity of long bones.
It has female predominance;it occurs in young adults and in the beginning of middle age.
The sclerosis typically involves the medullary cavity of the diaphyseal portion of the lower extremities,
most frequently the tibia,
with no essential periosteal reaction or soft-tissue abnormality.
IMOS may be unilateral or bilateral and...
Imaging findings OR Procedure Details
Case report:
A 88-year-old woman was admitted in the emergency orthopaedic department (ED) of our hospital for persistent pain at the left lower extremity.
The pain initially started suddenly two months before and the family orthopaedic doctor diagnosed greater trochanteric bursitis.
She underwent a corticosteroid injection in the trochanteric bursa with no improvement of the clinical outcome.
There was no history of trauma,
fever,
weight loss or family history of skeletal disorders.
She had undergone partial mastectomy after having diagnosed breast cancer four years ago....
Conclusion
IMOS is an uncommon benign condition of unkown aitiology.
Thediagnostic approach is based on the patient’s demographics,
the medical and accurate family history,
the clinical and laboratory (blood tests)and imaging( X-rays,
MRI,
C/T and Bone Scintigraphy) findings.
In our case,
we investigated the antalgic gait of an old age female patient with sclerotic intamedullary lesions on radiograph of the left femur.
Firstly the possibility of healing stress fracture or AFFs (associated with bisphosphonate therapy for osteoporosis) ruled out due to the absence of a localized...
References
1.
Abdul-Karim FW,
Carter JR,
Makley JT,
Morrison SC,
Helper SD,
Joyce MJ,
et al.
Intramedullary osteosclerosis.
A report of the clinicopathologic features of five cases.
Orthopedics.
1988;11(12):1667-75.
2.
Horwitz T,
T H.
Monomelic medullary osteosclerosis of unknown etiology.
Radiology.
1941;36:343‑51.
3.
Chanchairujira K,
Chung CB,
Lai YM,
Haghighi P,
Resnick D.
Intramedullary osteosclerosis: imaging features in nine patients.
Radiology.
2001;220(1):225-30.
4.
Puranik AD,
Singh N,
Maheshwari S,
Gupta N,
Wali P.
Intramedullary osteosclerosis of right femur confirmed on triphasic bone SPECT/CT in a patient...
Personal Information
Kostantinos Maniatis,
Resident of Orthopaedic,
4th Orthopaedic Clinic,
General Hospital of Athens "Asclepeion Voulas"
George Georgiades,
Consultant Orthopaedics,
4th Orthopaedic Clinic,
General Hospital of Athens "Asclepeion Voulas"
Evagelia Markou,
Resident of Radiology,
Computed Tomography Department,
General Hospital of Athens "Asclepeion Voulas"
Alexia Balanika,
Consultant Radiologist,
Computed Tomography Department,
General Hospital of Athens "Asclepeion Voulas"
