AMYLOID LESIONS OF BONE

Amyloid lesions of bone are rare, but should be considered in the differential diagnosis of skeletal abnormalities in a patient with generalized systemic disease.

Two forms of bone lesions are discussed.

(1) The more common form seen radiologically has been the involvement of multiple major joints and their paraarticular structures by masses of amyloid. These joints can exhibit only soft tissue swelling, but the masses of amyloid may invade the underlying bone, producing multiple small erosions. These have been most often in the hips, shoulders and elbows.

(2) The second form of amyloidosis of bone is caused by diffuse infiltration of the marrow. This may produce generalized demineralization of the skeleton, with collapse of vertebral bodies, resembling multiple myeloma and other diffuse skeletal diseases. This second form may, on the other hand, cause localized areas of bone destruction, as in our case. Another feature of this bone marrow form, hitherto undescribed but present in this case report, is the appearance of avascular necrosis of the femoral head, caused by deposition of amyloid in and around the blood vessels of the bone marrow.

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