Musculoskeletal ImagingAcro-osteolysis
destruction of bone of the acral areas (
extremities), especially related to occupational conditions.
Osteolysis may be severe in persons exposed to a number of industrial materials, such as polyvinylchloride. Similar abnormalities may also develop in persons inhaling vapours of other synthetic materials used in the manufacture of plastic products. The cause and pathogenesis of occupational acro-osteolysis are unclear.
Drumstick fingers and
watchglass nails are characteristic features.
The radiographic hallmark of the disorder is Osteolysis, which occurs predominantly in the terminal phalanges of the hands. Bandlike radiolucent areas across the waist of one or more terminal phalanges may occur along with tuftal resorption. The thumb is affected more commonly than the other digits. A bandlike resorption of the terminal phalanges may accompany other disorders, such as vasculitis, collagen disorders (e.g. scleroderma), psoriatic arthritis, pityriasis rubra pilaris, gout, epidermolysis bullosa, frostbite, thermal and electrical burns, hypertrophic osteoarthropathy, septic shock, progeria, multicentric reticulohistiocytosis and neuropathic osteoarthropathy, but the pattern of osteolysis generally differs from that seen in occupational acro-osteolysis. The sacroiliac joints, the foot, and sometimes other skeletal structures may also be involved in certain types of acro-osteolysis. If the exposure to polyvinylchloride is halted, slow improvement of the radiographic abnormalities may be seen.
DR