[Osteolytic and osteosclerotic lesion of the femur associated with pustulosis palmaris plantaris].

The cases with pustulosis palmaris et plantaris associated with lesions in sterno-cost clavicular region, spine and ilio sacral joint have been in the previous literatures. We encountered four rare cases of this pustulosis in association with femoral lesion. We mainly reported their radiological and pathologic findings. Three cases had lesions in the diaphysis of the femur, while one case had lesion in the lesser trochanter. The average age was 55.5 years (range 53-60) All patients complained of thigh pain. Three cases suffered sterno cost clavicular pain also. Laboratory data showed the elevation of white blood cell number, ESR and tested positive for C-reactive protein. The radiological findings showed osteolytic lesions of the femoral cortex at the onset of the disease, followed by thickening and sclerosis in the cortex. A biopsy was performed in three cases and the pathological results showed no malignancy. The specimens showed only chronic inflammation. Pathological results and radiological abnormalities suggested that femoral lesion of pustulosis palmaris et plantaris originated from the periostenum or the cortex of bone.