Osteopoikilosis in an ancient skeleton: more than a medical curiosity

Spotted bones in an osteopoikilosis-related disease (Buschke Ollendorff Syndrome): Identifying this rare condition from the lab to the field

OBJECTIVE

To improve the differential diagnosis of osteopoikilosis in past populations using a clinical case as an example of this rare condition.

MATERIALS

A patient referred to our Genetic Service with suspected Buschke Ollendorff Syndrome after finding a connective nevus.

METHODS

Radiological images from different body regions were accompanied by a genetic study using next-generation sequencing.

RESULTS

Small circular-to-ellipsoid sclerotic lesions were found in the epiphysis and metaphysis of long bones, as well as in the pelvis. These lesions were bilaterally distributed and with well-defined margins, compatible with the characteristics of Buschke Ollendorff Syndrome, bone manifestation osteopoikilosis. A heterozygous mutation on LEMD3 (NM_001167614:c.1918 + 1G > C) was identified by next-generation sequencing. Based on this confirmed case, we have discussed the most probable causes of similar bone lesions found in the archaeological record.

CONCLUSION

It has been demonstrated how a current case of a rare disease can provide useful tools to improve the differential diagnosis of this disease in ancient skeletons.

SIGNIFICANCE

This work underlines the great need for multidisciplinary platforms that integrates clinical research into paleopathology in order to successfully address the study of rare diseases from the past.

LIMITATIONS

Since OPK is only detected by X-rays, suspected cases of this bone lesion will only be identified when radiographs are taken for other purposes.

SUGGESTIONS FOR FURTHER RESEARCH

Retrospective and large-scale studies of radiographs from other research in past populations.

Osteopoikilosis in a patient with rheumatoid arthritis complicated with dry eyes

Osteopoikilosis is an uncommon sclerosing bone dysplasia of unknown etiology. It is usually detected as a coincidental finding at radiographic examination. Mild joint pain and swelling may be seen in 15-20% of cases. Osteopoikilosis is rarely associated with rheumatoid arthritis. In this case report a young man with osteopoikilosis who was diagnosed as having rheumatoid arthritis complicated with dry eyes is presented. Although patients with osteopoikilosis may have articular symptoms, those patients should be carefully examined for a possible association with a rheumatic condition.