Diffuse Sclerosing Osteomyelitis (DSO) is an uncommon form of chronic inflammation of bone that needs to be distinguished from suppurative osteomyelitis.
Classification: a subtype of primary chronic osteomyelitis (PCO)
Pathogenesis: poorly understood, but probably is not bacterial
Features: nonsuppurative inflammatory disease of bone
Radiologic bone changes are key to the diagnosis:
(1) diffuse (not limited to one bone)
(2) intermingled sclerotic and osteolytic lesions
(3) solid periosteal reaction or external bone resorption
Patients show relatively prompt improvement following the start of bisphosphonate therapy.
The diagnosis requires exclusion of other causes of osteomyelitis.
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