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| Coronal IR |
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| Coronal T1 |
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| Coronal T1 |
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| Rorschach
Young patient who presented with low back ache and came in for an MRI of the lumbar spine.
Lumbar spine images demonstrated a marked posterior disc extrusion at L4/5 accounting for the patient’s symptoms.
However on the routine coronal IR images multiple well defined ovoid hypointense foci were noticed in the pelvic girdle and femur.
An additional coronal T1 was acquired which demonstrates multiple numerous dark foci representing bone islands
Reminded me of the facial features of Rorshach from the cult graphic novel “The Watchmen”
Diagnosis: Osteopoikilosis
Osteopoikilosis:
- is a sclerosing bone dysplasia with multiple
enostoses
- develop during childhood and do not regress and
therefore are seen in all age groups
- asymptomatic
- often found concurrently with osteopathia striata,
and melorheostosis
- bone islands of osteopoikilosis are typically
clustered around joints and align themselves
parallel to surrounding trabeculae
- found in the appendicular skeleton and pelvis
- axial skelton is largely spared. It is rare for the
skull vault to be involved
- is one of the skeletal “Don’t touch” lesions.
References:
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