Background: Osteopoikilosis is a benign, uncommon disorder that is inherited by the autosomal dominant gene. Multiple benign enostoses are present in this specific kind of sclerosing skeletal dysplasia, which can be mistaken for osteoblastic skeletal metastases.
Case Presentation: We present here a case of 50-year-old male patient with pain in lower back for 3 months. His pelvic X-ray showed few sclerotic rounded lesions in ilium, acetabulum and proximal femur. His MRI pelvis showed T1WI and T2WI hypo intense focal lesions in ilium and acetabulum. His 99mTc MDP bone scan was done showing no focal abnormal uptake in lesion reported on pelvic X-ray and MRI. These features are suggestive of Osteopoikilosis, ruling out osteoblastic skeletal metastasis.
Conclusion: Osteopoikilosis is usually an incidental finding on radiograph. Both x-ray and MRI findings can mimic skeletal metastasis, but a normal bone scan can rule out metastasis and is useful if metastatic disease is thought to be a possibility.
Key words: Osteopoikilosis, Tc-99m MDP bone scan, Enostoses, Skeletal Scintigraphy, case report.
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