ICCBH2013 Poster Presentations (1) (201 abstracts)
‘Bone in bone' sign in juvenile osteoporosis in a 13-year-old girl
Maria Sakalidou 2 , Eri Atsali 1 , Vasiliki Bizimi 1 , Gregory Skaradavos 1 , Alexia Balanika 2 , Athanasios Athanasakos 1 , Efthymia Alexopoulou 1 & Olymbia Papakonstantinou 1
1University Hospital of Athens ‘ATTIKON’, Athens, Greece; 2Asklepion General Hospital, Athens, Greece.
Background: We present an interesting case of a young child under bisphosphonates, for the treatment of juvenile osteoporosis (IJO), that developed a ‘bone in bone sign’, in several vertebral bodies, evident both on radiographs (CRX) and on magnetic resonance (MR) studies.
Presenting problem: A 13-year-old girl was admitted in our hospital complaining with thoracolumbar pain. The patient had been diagnosed with IJO 2 years ago because of.a history of a low energy fracture of a thoracic vertebra and a low BMD, measured by DEXA (Z-score: −2.2). The girl was receiving bisphosponates for 1 year and 6 months before her current admission.
She underwent a new BMD and radiographic study, with CRX and MRI of the thoracolumbar spine and the pelvis.
Clinical management: Bone, new, densitometry values, by DEXA, were normal (Z-score: −1.2).
Radiographs of the thoracolumbar spine and pelvis revealed a ‘bone within a bone’ appearance of the vertebrae and iliac bones. MR imaging of the thoracic and lumbar spine, showed a moderately low signal of the vertebral end plates, producing a ‘frame’ like picture, on T1 weighted images after fat-suppression and administration of contrast agent.
In a retrospective study of previous radiographs of the thoracic spine, there was a reduction of the visual height of the vertebral bodies, and the uncalcified end plates were barely visible.
Discussion: The bone within bone’ radiographic pattern, has been frequently described in IJO patients and it is either attributed to the disease it’s self or the treatment with bisphosphonates or even the termination of the use of such drugs.
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Bone Abstracts
ISSN 2052-1219 (online)
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