Unusual bone trabeculation in a patient with macroglobulinaemia simulating fibrogenesis imperfecta ossium

Radiographs of a patient with macroglobulinaemia revealed a widespread skeletal abnormality with less numerous but thicker trabeculae particularly in the sub-articular regions. These appearances were indistinguishable from those previously recorded in a case of fibrogenesis imperfecta ossium and had been thought to be specific for this condition. In both patients weakening of the bone together with skeletal stresses of a fairly active life over a long period of time had given rise to similarly placed tracts of thickened bone trabeculae. Histological studies of the present case showed that the weakness was mainly due to increased osteoclasis which appeared to be related to a change in the blood supply of the marrow. In addition a moderate grade of osteomalacia was recognized.