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Lost bones: differential diagnosis of acro-osteolysis seen by the pediatric rheumatologist

Authors
  • Limenis, Elizaveta1
  • Stimec, Jennifer1
  • Kannu, Peter1
  • Laxer, Ronald M.1
  • 1 The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada , Toronto (Canada)
Type
Published Article
Journal
Pediatric Rheumatology
Publisher
Springer Science and Business Media LLC
Publication Date
Jul 14, 2021
Volume
19
Issue
1
Identifiers
DOI: 10.1186/s12969-021-00596-0
Source
Springer Nature
Keywords
Disciplines
  • Review
License
Green

Abstract

IntroductionAcro-osteolysis is a radiographic finding which refers to bone resorption of the distal phalanges. Acro-osteolysis is associated with various conditions and its presence should prompt the clinician to search for the underlying etiology. The aim of this review is to discuss disorders with which acro-osteolysis is associated and their distinguishing features, with a focus on the pediatric population.MethodsA targeted literature review was performed using the term “acro-osteolysis” in combination with other key terms. The primary search results were supplemented using reference citations. Articles published prior to the year 2000 were included if they described additional associations not encountered in the more recent literature.ResultsGenetic disorders (particularly primary hypertrophic osteoarthropathy and skeletal dysplasias) and rheumatic diseases (particularly psoriatic arthritis and systemic sclerosis) are the most frequently encountered conditions associated with acro-osteolysis in children. Hyperparathyroidism, neuropathy, local trauma and thermal injury, and spinal dysraphism should also be included in the differential diagnosis.ConclusionAlthough acro-osteolysis is uncommon, its presence should prompt the clinician to consider a differential diagnosis based on clinical and radiographic features.

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