Musculoskeletal ImagingMulticentric osteolysis
an idiopathic disorder characterized by multifocal joint destruction seen initially in infancy or childhood. The disease is characterized by pain and swelling of the hands, wrists, feet, ankles and elbows. Multicentric osteolysis is also referred to as carpal tarsal osteolysis or disappearing carpal bones. On radiographs, patients typically reveal
osteoporosis, progressive osteolysis and deformity, which may simulate the changes occurring in juvenile chronic arthritis.
Although this condition can be further classified into two types, multicentric osteolysis with nephropathy and hereditary multicentric osteolysis, not all cases fit neatly into one of these two categories.
Multicentric osteolysis with nephropathy has an early age of onset of the osteolysis and progressive renal failure leading to death by the third decade of life. Patients do not have a family history of either osteolysis or renal disease. Progressive disappearance of the carpus and sometimes the tarsus with tapering of the adjacent tubular bones is observed on radiographs.
Hereditary multicentric osteolysis has a familial distribution and later disease onset (typically around the age of 34 years). Adolescents experience an asymptomatic period marked by a varying amount of carpal and tarsal osteolysis associated with progressive deformity. Although dissolution of carpus and tarsus is also seen in this category, in most cases it is not associated with tapering of the adjacent tubular bones.
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