Also called: Osteopathia Striata Syndrome or MSBD
In researching the medical literature for any updated information, I came across a list of another rare two dozen syndrome that can either cause lymphedema or manifest it as a comorbidity. I will be creating information pages on all those conditions and I hope they can help others who have one of those syndromes.
Unfortunately, there is little information available in general and no abstracts or studies have been released on the condition since 1996.
Related Terms: Lymphedema, ostopathia, osteopoikilosis, bone density, MSBD, fibrous dysplasia, recalcitrant lateral epicondylitis, osteopathia striata, diffuse osteosclerosis, skeletal dysplasia, WTX, genotype, phenotype, X-linked
Jan. 22, 2012
It is a rare form of osteosclerosis caused by a lack of calcium in the bones. The lack of calcium also leads to bone and joint deformities. It was first described by Voorhoeve and named by Fairbank in 1924, and its prevalence is less than 0.1 per 1 million.
Eight specific symptoms are in the medical ltierature, they include:
Limb deformity in affected limb
Bone pain in affected limb
Restricted movement in affected limb
Overall treatment will be determined by the extent of the condition itself and/or comorbidities.
For example. manual decongestive therapy and the wearing of compression garments will treat the lymphedema.
Surgery may be necessary for correction of bone and/or joint difficulties.
Autosomal dominant disorder
The genetic mode of transmission is not yet definitively decided. Some believe the dysplasia is inherited as an autosomal dominant trait. Others propose an X-linked form of the disease associated with significant cranial abnormalities in which boys are more severely affected. There is a high degree of variability in the clinical expression of the disease. Exper Consult.
Mixed sclerosing bone dystrophy. Report of a case and review of the literature. Jul 1996
Belzunegui J, Plazaola I, Uriarte E, Gonzalez C, Figueroa M.
Rheumatology Unit, Hospital N.S. Aranzazu, San Sebastian, Spain.
A 63-year old woman was admitted because of hip pain. Radiographs showed multiple round and oval sclerotic lesions involving humeral heads, pelvis, vertebral bodies and both femoral bones. Diaphyseal periosteal proliferation was found in metatarsal bones. A diagnosis of mixed sclerosing bone dystrophy was made. We review clinical, epidemiological and radiological findings of this entity.
An unusual case of mixed sclerosing bone dystrophy presenting with morning stiffness and joint swelling in childhood: a case report.
Foeldvari I, Cairns RA, Petty RE, Cabral DA.
Department of Pediatrics, British Columbia's Children's Hospital, University of British Columbia, Canada.
We describe a case of a 16 year old native Indian girl with pain, morning stiffness and foot swelling who had radiographic changes consistent with mixed sclerosing bone dystrophy (MSBD) combined with fibrous dysplasia.
Mixed sclerosing bone dystrophy presenting with upper extremity deformities. A case report and review of the literature. Feb. 1992
Ostrowski DM, Gilula LA.
Brockwood Orthopedic Associates, Birmingham, Alabama.
We present a detailed study of a 59-year-old white woman with mixed sclerosing bone dystrophy: the rare occurrence of two or more sclerosing bone dysplasias in a single subject. She exhibited features of osteopoikilosis, osteopathia striata and melorheostosis. The symptoms were primarily the result of the melorheostosis lesions which were distributed within the C6 sclerotome. This is an unusual case of mixed sclerosing bone dystrophy in that the upper extremity was the main site of involvement, instead of the usual symmetrical involvement of all limbs. The patient developed a recalcitrant lateral epicondylitis in the un-involved contralateral elbow that required surgical treatment.
Mixed sclerosing bone dystrophy with features resembling osteopoikilosis and osteopathia striata. Jun 1991
Cantatore FP, Carrozzo M, Loperfido MC.
Department of Rheumatology, University of Bari, Italy.
A 64-year old man, presenting pain in his back and left sciatalgia, was found to have a mixed sclerosing bone dystrophy with features resembling osteopoikilosis and osteopathia striata. Oval and round densities were found in the humeral heads, elbows, wrists, hands, pelvis, knees, feet. Striata densities were in the diaphyses of metacarpal and metatarsal bones. Bone scan was negative. Standard biochemical examinations of the blood and urine were negative. According to our investigations no evidence of osteopoikilosis other sclerosing bone dystrophies were found in the family of our patient. These data were discussed.
Mixed-sclerosing-bone-dystrophy (osteopathia striata and osteopetrosis) and Cushing's syndrome. 1990
Proto G, Bertolissi F, Moretti C, Corsi M.
Servizio di Endocrinologia, Ospedale Generale di Udine, Italy.
Erratum in Bone 1990;11(6):453.
Keywords: Osteopathia striata; Osteopetrosis; Cushing's syndrome
We present a 33-year-old female patient with the unusual association of mixed sclerosing bone dysplasia and Cushing's syndrome. The patient had the classical features of cortisol overproduction and investigation showed bilateral adrenal adenomas and radiographic abnormalities in bone of osteopathia striata and osteopetrosis: the mixed-sclerosing-bone-dystrophy (MSBD).
Mixed-sclerosing-bone-dystrophy: 42-year follow-up of a case reported as osteopetrosis. 1986
Pacifici R, Murphy WA, Teitelbaum SL, Whyte MP.
We present a detailed metabolic investigation and 42-year radiological follow-up of a 52-year-old man with mixed-sclerosing-bone-dystrophy, the rare occurrence of two or more distinct patterns of sclerosing-bone-dysplasia (e.g., osteopathia striata, osteopoikilosis, melorheostosis) in a single subject. Review of radiographs from 1942, when he was reported to have osteopetrosis, demonstrated diffuse osteosclerosis, osteopathia striata, osteopoikilosis, and focal cortical hyperostosis. Forty-two years later, there had been significant progression and evolution of his skeletal disease with the appearance of new areas of osteopathia striata and osteopoikilosis and a generalized increase in skeletal mass as assessed radiographically. Presence of subperiosteal bone apposition on biopsy of the iliac crest together with chronic mild hypocalcemia, secondary hyperparathyroidism, and hypophosphatemia suggested that enhanced bone formation, perhaps with defective skeletal resorption, is a fundamental abnormality which accounts for the increased bone mass of this patient.
The male phenotype in osteopathia striata congenita with cranial sclerosis. Oct 2011
Keywords: WTX;osteopathia striata with cranial sclerosis; skeletal dysplasia
Osteopathia striata with cranial sclerosis (OSCS) is an X-linked disease caused by truncating mutations in WTX. Females exhibit sclerotic striations on the long bones, cranial sclerosis, and craniofacial dysmorphism. Males with OSCS have significant skeletal sclerosis, do not have striations but do display a more severe phenotype commonly associated with gross structural malformations, patterning defects, and significant pre- and postnatal lethality. The recent description of mutations in WTX underlying OSCS has led to the identification of a milder, survivable phenotype in males. Individuals with this presentation can have, in addition to skeletal sclerosis, Hirschsprung disease, joint contractures, cardiomyopathy, and neuromuscular anomalies. A diagnosis of OSCS should be considered in males with macrocephaly, skeletal sclerosis that is most marked in the cranium and the absence of metaphyseal striations. The observation of striations in males may be indicative of a WTX mutation in a mosaic state supporting the contention that this sign in females is indicative of the differential lyonization of cells in the osteoblastic lineage.
Osteopathia striata, an autosomal dominant disorder, has been diagnosed in a 19 year old mildly retarded woman. In addition, she has macrocephaly, a leonine facis, disfigurement of the lower jaw, a cleft palate and mixed hearing loss. Roentgenograms of the skull and long bones show thickening of the calvarium, particularly at the absed, mandibular hyperplasia, and striations in the long bones and pelvis. Except for the cleft palate, which has not been previously reported, and the retardation, which appears to be quite uncommon in this condition, these findings are characteristic of osteopathia striata. Because the disorder may resemble several other conditions, the differential diagnosis should include osteopoikilosis, the autoosomal dominant form of esteopetrosis, and hyperostosis corticalis generalisata.
Mixed Sclerosing Bone Dystrophies
Mixed-sclerosing-bone-dystrophy: report of a case and review of the literature. 1981
Sclerosing bone dysplasias: review and differentiation from other causes of osteosclerosis Nov-Dec 2011
99mTc-pyrophosphate bone imaging in osteopoikilosis, osteopathia striata, and melorheostosis May 1978
Osteopathia Striata with Cranial Sclerosis; OSCS
Osteopathia striata with cranial sclerosis affecting three family members
Key words Osteopathia striata - Cranial sclerosis - Mandible - Osteopoikilosis - Osteosclerosis
Two novel WTX mutations underscore the unpredictability of male survival in osteopathia striata with cranial sclerosis. Sept 2010
Keywords: male survival;mutation update; osteopathia striata with cranial sclerosis; two novel WTX mutations
Osteopathia striata with cranial sclerosis owing to WTX gene defect. Jan. 2010
Keywords: osteopathia striata with cranial sclerosis; WTX; genotype; phenotype
Osteopathia striata with cranial sclerosis: highly variable phenotypic expression within a family. Oct 1997
I Have Mixed Sclerosing Bone Dystrophy Experience Project
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