Idiopathic Osteosclerosis Isolated — ORE Part 1 MCQ

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EasyRadiology & ImagingIdiopathic Osteosclerosis IsolatedORE Part 1

A routine radiograph shows a solitary, well-defined, round radiopacity measuring 8 mm in the body of the mandible. It is uniformly radiopaque, has no surrounding radiolucent rim and is separate from the roots of adjacent vital teeth. What is the most likely diagnosis?

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Correct answer: E — Idiopathic osteosclerosis

The diagnosis is **idiopathic osteosclerosis**. It is an incidental, non-expansile focus of dense bone, typically seen as a homogeneous, well-defined radiopacity in the mandible. Crucially, this lesion is separate from teeth and the adjacent teeth are vital. Cementoblastoma is fused to a tooth root and usually has a radiolucent peripheral rim. Condensing osteitis is a periapical sclerotic reaction associated with pulpal inflammation, so would be related to a carious, heavily restored or non-vital tooth. Mature cemento-osseous dysplasia is usually tooth-bearing/periapical and commonly has a radiolucent rim. An osteoma is generally a cortical or surface-based bony mass rather than a small intramedullary dense bone island. The described features therefore most strongly support idiopathic osteosclerosis.

Reference: Melo SLS, et al. Idiopathic osteosclerosis in the maxillomandibular area. Radiology and Oncology. 2018. https://pubmed.ncbi.nlm.nih.gov/30244367/