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Musculoskeletal Imaging

Sclerosis

a hardening or induration, as of bone (osteosclerosis) or other tissues. Eburnation is a closely related process in which bone sclerosis is evident on radiographs. Osteosclerosis is a feature of innumerable diseases.

Among the disorders in which bone sclerosis is noted are renal osteodystrophy, hyperparathyroidism, some forms of plasma cell myeloma, calcium pyrophosphate dihydrate crystal deposition disease and ankylosing spondylitis. Sclerosis of phalangeal tufts may be noted in systemic lupus erythematosus, rheumatoid arthritis and sarcoidosis; it may also be present as a normal finding.

Skeletal metastases and various other disorders, such as Pagets disease, lymphoma, Hodgkins disease, tuberculous spondylitis, plasmacytoma and POEMS syndrome, may lead to the development of an entirely radiodense vertebral body (ivory vertebral body).

Segmental sclerosis of vertebral bodies is characterized by increased radiodensity of peridiscal vertebral bone. Usually a specific cause cannot be identified. Radiographic features include bone lysis, bone sclerosis or both, sometimes with selective involvement of the anteroinferior portion of the vertebral body, especially of L4 and, less frequently, L3. A hemispheric band of sclerosis extends for a variable distance from the anterior and inferior margins of the vertebral body to its central portion. Narrowing of the intervertebral disc space and involvement of the adjacent vertebral body are evident in some instances.

Hereditary multiple diaphyseal sclerosis, or Ribbings disease, is a frequently asymptomatic disorder of the extremities, perhaps related to progressive diaphyseal dysplasia.

Various other types of sclerosis unrelated to sclerosis of bones may also involve the musculoskeletal system.

Progressive systemic sclerosis, or scleroderma, is a generalized disorder of connective tissue affecting several organ systems.

Tuberous sclerosis is a widely occurring dysplasia of unknown pathogenesis with a classic clinical triad of epileptic seizures, mental retardation and skin lesions (hamartomas). The disorder involves multiple organ systems and shares some characteristics with neurofibromatosis and polyostotic fibrous dysplasia.

Also, see arteriosclerosis and multiple sclerosis.

DR