Abstract
KEY CLINICAL MESSAGE: Osteopoikilosis is an asymptomatic osteosclerotic dysplasia, of autosomal dominant inheritance, which does not cause deformity or alteration in bone development, of incidental diagnosis. The differential diagnosis should be made with osteoblastic metastases, among others, especially if it is asymmetric and in patients over 50 years of age. ABSTRACT: Osteopoikilosis is a rare benign bone disease, characterized by the appearance of bone islands in the osseous tissue, which could be confused with bone metastasis. We present the case of a 69-year-old man, in whom the presence of multiple punctate lesions spread throughout the skeleton was discovered after an accidental fall with a fracture of the T11 vertebral body complicated by acute osteomyelitis. The importance of this clinical case lies in the need to rule out neoplastic cause after the vertebral fracture, since osteopoikilosis is usually an incidental finding and the specific characteristics of the radiological image would avoid unnecessary interventions.