Fig. 1

Radiological findings of 2 patients with multicentric carpotarsal osteolysis syndrome. In Patient 1, radiographs of the hands (a) and feet (b) obtained at 4 years old show severe bone resorption of the carpal and tarsal bones. Bone erosions are also noted in the proximal ends of metacarpal and metatarsal bones and the distal ends of the talus and calcaneus. Note that the distal metacarpal and metatarsal bones and the phalanges remained well-preserved at that time. Incidentally, there are fractures of the left 2nd and 3rd metatarsal necks (arrows). Follow-up radiographs of the hands (c) and feet (d) at the age of 20 show marked progression of bone resorption and associated joint contracture. In addition to the carpal and tarsal bones, the metacarpal and metatarsal bones, phalanges, distal radii, and ulnae are extensively involved. In Patient 3, radiographs of the hands (e) and feet (not shown) obtained at 1 year of age show multiple areas of osteolysis predominantly involving the carpal and tarsal bones. In addition, an abdominal aortic aneurysm was incidentally detected with renal ultrasonography (not shown), and a subsequently taken abdominal CT angiograph (f) confirmed fusiform aneurysms involving the infrarenal aorta and bilateral common iliac arteries (arrows)