Abstract：
A 30-yr-old man developed right lower leg pain and a palpable solid mass. Radiographic imaging revealed a periosteal reaction with an exostotic mass arising from the right distal fibula. Generalized skeletal osteosclerosis with periosteal reaction was discovered on a radiographic skeletal survey. A biopsy of the right fibular mass revealed reactive woven bone. The patient was referred to a metabolic bone disease clinic, where laboratory values were consistent with secondary hyperparathyroidism and increased bone turnover. A DXA bone density scan revealed high bone density, with an L1-4 spine Z-score of +9.3, a left femoral neck Z-score of +8.5, and a total hip Z-score of +6.5. A dental exam revealed generalized gingival inflammation, teeth mobility, generalized horizontal alveolar bone loss and widening of the periodontal ligament space, increased bone density around the teeth, and thickening of the radicular lamina dura. An extensive evaluation was performed, with the result of a single test revealing the diagnosis. The differential diagnoses of osteosclerosis affecting the skeleton, teeth, and oral cavity are discussed.
A 30-yr-old man developed, over a short period, pain in his lower right leg accompanied by a hard mass. He also reported weight loss and night sweats for the past 6 months. After evaluation by his primary physician, an X-ray was ordered that reported a bony mass arising from the right fibula bone. A biopsy was performed of the mass, but no evidence of cancer or any other specific abnormality was found. The patient was then referred to a bone disease specialty clinic. Laboratory tests revealed a large increase in how quickly the patient’s skeleton was remodeling, affecting the balance of bone formation and removal involved in maintaining a healthy skeleton. A bone density scan reported that the patient had very dense bones. Other unusual changes were also discovered in a dental exam, suggesting bone thickening. After an extensive evaluation, a single blood test revealed the cause of the fibular bone mass and dense bones.
A 30-yr-old man developed, over a short period, pain in his lower right leg accompanied by a hard mass. He also reported weight loss and night sweats for the past 6 months. After evaluation by his primary physician, an X-ray was ordered that reported a bony mass arising from the right fibula bone. A biopsy was performed of the mass, but no evidence of cancer or any other specific abnormality was found. The patient was then referred to a bone disease specialty clinic. Laboratory tests revealed a large increase in how quickly the patient’s skeleton was remodeling, affecting the balance of bone formation and removal involved in maintaining a healthy skeleton. A bone density scan reported that the patient had very dense bones. Other unusual changes were also discovered in a dental exam, suggesting bone thickening. After an extensive evaluation, a single blood test revealed the cause of the fibular bone mass and dense bones.
摘要：
一名30岁的男子出现右小腿疼痛和明显的固体肿块。放射学成像显示，右侧腓骨远端有外生性肿块引起的骨膜反应。在影像学骨骼检查中发现了具有骨膜反应的广义骨骼骨硬化。右腓骨肿块的活检显示反应性编织骨。病人被转诊到代谢性骨病诊所,其中实验室值与继发性甲状旁腺功能亢进和骨转换增加一致。DXA骨密度扫描显示骨密度高,L1-4脊柱Z评分为+9.3，左股骨颈Z评分为+8.5，总髋关节Z评分为+6.5。牙科检查显示全身牙龈发炎，牙齿的流动性,广泛的水平牙槽骨丢失和牙周膜间隙的扩大，牙齿周围的骨密度增加，和神经根膜硬膜增厚。进行了广泛的评估，单一测试的结果揭示了诊断。骨硬化影响骨骼的鉴别诊断，牙齿,和口腔进行了讨论。
一个30岁的男人开发,在短时间内，他的右小腿疼痛伴有硬块。他还报告了过去6个月的体重减轻和盗汗。经过他的主治医生的评估，下令进行X射线检查，报告右腓骨骨产生骨块。对肿块进行了活检，但没有发现癌症或任何其他特定异常的证据。然后将患者转诊到骨病专科诊所。实验室测试显示，患者骨骼重塑的速度大幅增加，影响维持健康骨骼的骨形成和去除的平衡。骨密度扫描报告患者的骨骼非常致密。在牙科检查中还发现了其他不寻常的变化，提示骨增厚.经过广泛的评估，一次血液检查显示腓骨骨量和致密骨骼的原因。
一个30岁的男人开发,在短时间内，他的右小腿疼痛伴有硬块。他还报告了过去6个月的体重减轻和盗汗。经过他的主治医生的评估，下令进行X射线检查，报告右腓骨骨产生骨块。对肿块进行了活检，但没有发现癌症或任何其他特定异常的证据。然后将患者转诊到骨病专科诊所。实验室测试显示，患者骨骼重塑的速度大幅增加，影响维持健康骨骼的骨形成和去除的平衡。骨密度扫描报告患者的骨骼非常致密。在牙科检查中还发现了其他不寻常的变化，提示骨增厚.经过广泛的评估，一次血液检查显示腓骨骨量和致密骨骼的原因。
