Resorption of hand bones into the blood
Early changes of acroosteolysis can be detected by x-ray. In this radiograph there is dissolution and fragmentation of the bone in several of the terminal phalanges.~CDC
Acroosteolysis is resorption of the distal bony phalanges . Acroosteolysis has two patterns of resorption in adults : diffuse and bandlike.
The diffuse pattern of resorption has a widely diverse differential diagnosis which includes: pyknodysostosis , collagen vascular disease and vasculitis , Raynaud's neuropathy , trauma, epidermolysis bullosa , psoriasis , frostbite , sarcoidosis , hypertrophic osteoarthropathy , acromegaly , and advanced leprosy .[ 1] [ 2] [ 3]
The bandlike pattern of resorption may be seen with polyvinyl chloride exposure and Hadju-Cheney syndrome .[ 1]
A mnemonic commonly used for acro-osteolysis is PINCHFO .[ 4]
P yknodysostosis, P soriasis,
I njury (thermal burn, frostbite),
N europathy (diabetes ),
C ollagen vascular disease (scleroderma , Raynaud's),
H yperparathyroidism ,
F amilial (Hadju-Cheney, progeria ),
O ccupational (polyvinyl exposure),
Acroosteolysis may be associated with minimal skin changes or with ischemic skin lesions that may result in digital necrosis .[ 5] : 665
See also
References
^ a b Yu, Joseph. Musculoskeletal Imaging, Case Review Series. 2008.
^ Romero, Belinchón; Ramos Rincón, J.M.; Reyes Rabellc, F. "Nail Involvement in Leprosy" . ACTAS Dermo-Sifiliograficas . Academia Española de Dermatología y Veneralogía. Archived from the original on 28 April 2015. Retrieved 28 June 2014 .
^ Baran, Robert; de Berker, David A. R.; Holzberg, Mark; Thomas, Luc (July 23, 2012). Baran and Dawber's Diseases of the Nails and their Management (4th ed.). Wiley. ISBN 978-0470657355 . Retrieved 28 June 2014 .
^ Jones, Jeremy. "Acro-osteolysis (mnemonic) | Radiology Reference Article | Radiopaedia.org" . Radiopaedia . doi :10.53347/rID-12202 .
^ Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine . (6th ed.). McGraw-Hill. ISBN 0-07-138076-0 .