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Ramon Rodriguez, MD, Ginger Bryant, MD, Prasit
Nimityongskul, MD, University of South Alabama, Mobile, AL
Acro-osteolysis is defined as
dissolution of bone or loss of calcium in bone of the phalanges
that is seen primarily on radiographic examinations. Acro-osteolysis
has been described in association with the use of environmental
toxins, genetic disorders, systemic disorders, trauma, and
infections. Environmental toxin induced acro-osteolysis has
been associated with the use of polyvinyl chlorides. Genetic
disorders that are both autosomal dominant, as in Hadju-Cheney
syndrome, and autosomal recessive, as in Mandibulo-acral dysplasia
have been associated with acro-osteolysis. Systemic disorders
such as scleroderma, Reiter's disease, and psoriatic arthritis
have been linked to acro-osteolysis.
We present a case report of a
previously healthy eleven year old male who developed pain
and swelling in his thumb. Laboratory work up which consisted
of complete blood count, erythrocyte sedimentation rate, and
C reactive protein were unremarkable. Radiographic examination,
which consisted of plain radiographs and magnetic resonance
imaging, revealed osteolysis of his distal phalanx of his
right thumb.
The patient was free of any genetic
or systemic disease, had no evidence of infection and did
not work with environmental toxins. The patient's history
was significant for thumb sucking of the affected digit. Acro-osteolysis
in this child is attributed to chronic thumb sucking. A review
of the literature does not reveal any previously documented
cases of acro-osteolysis with respect to finger sucking of
which we are aware.
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