en Reumatology Reumatology case report case report <p><font face="Times New Roman" size="3"> </font><font face="Times New Roman"><b><i><span style="color: blue font-size: 10pt">Background: </span></i></b><span style="font-size: 10pt">Osteopoikilosis</span><span style="font-size: 10pt"> (OPK) is a rare inherited condition of the bones, transmitted as an autosomal dominant trait characterized by numerous hyperostotic areas that tend to localize in periarticular osseous regions. It is usually asymptomatic and is often diagnosed incidentally during x-rays made by other reasons. We present a case of 34-year-old man suffering from polyarthralgia and low back pain.</span></font></p><p><font face="Times New Roman" size="3"> </font><font face="Times New Roman"><b style="mso-bidi-font-weight: normal"><i><span style="color: blue font-size: 10pt">Case presentation</span></i></b><i><span style="color: blue font-size: 10pt">:</span></i><span style="font-size: 10pt"> A 34-year-old male patient, smoking 40 packs yearly and alcoholic was referred to our department of rheumatology, complaining of polyarthralgia which started 3 years ago and involving large and small joints. He reported the presence of pelvic pain mostly located at both hip joints and in the two ankles. On radiologic examination, numerous, symmetric, well defined, sclerotic lesions were identified on shoulder, wrist, ankles, pelvis, and on spine.<span style="mso-spacerun: yes"><font size="2"> </font></span>The size of the lesions varied from 2 to 9 millimeters. These spots were located on spongious bone tissue, and in the inner bone cortex located bilaterally in the epiphyses and metaphyses. We concluded the diagnosis of OPK. His mother was found to have the same lesions without any symptoms.</span></font></p><p><font face="Times New Roman" size="3"> </font><font face="Times New Roman"><b><i><span style="color: blue font-size: 10pt">Conclusion: </span></i></b><span style="font-size: 10pt">OPK may be an isolated finding or associated with other pathologies, e.g. skin manifestations, rheumatic and/or skeletal disorders. The main differential diagnosis is osteoblastic metastasis.</span></font></p><p><font face="Times New Roman" size="3"> </font></p> Osteopoikilosis, Diagnosis, Osteoblastic metastasis, Treatment. 177 179 http://caspjim.com/browse.php?a_code=A-10-246-1&slc_lang=en&sid=1 Mahbouba Jguirim mahbouba.jguirim@yahoo.fr 10031947532846003595 10031947532846003595 Yes University of medicine of Monastir Mondher Golli mondher.golli@rns.tn 10031947532846003596 10031947532846003596 No University of medicine of Monastir Amira Mhenni mhenniamira@yahoo.fr 10031947532846003597 10031947532846003597 No University of medicine of Monastir Walid Mnari walid.mnari@gmail.com 10031947532846003598 10031947532846003598 No University of medicine of Monastir Naceur Bergaoui naceur.bergaoui@rns.tn 10031947532846003599 10031947532846003599 No University of medicine of Monastir