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A 17-year-old boy presented with a 2-month history of pain in his right wrist. Physical examination did not reveal any local swelling, redness, tenderness or deformity. Radiograph of both wrists and hands revealed multiple symmetric, well-defined, sclerotic lesions involving the carpal bones, metacarpals and phalanges (figure 1A,B). Radiograph of pelvis showed similar lesions (figure 1D). Biochemical profile revealed normocalcaemia, normophosphataemia and age-appropriate serum alkaline phosphatase. Bone scintigraphy did not reveal any increased osteoblastic activity (figure 1C,E). Family screening showed radiologically …
Contributors RP prepared the manuscript. PD conceptualised the manuscript and provided overall guidance. TB helped procure the radiological images. SKB and AB edited the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Parental/guardian consent obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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