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Radiographs of the right humerus obtained at 4 years of age (Panel A), 24 years of age (Panel B), and 30 years of age (Panel C) in a patient with polyostotic fibrous dysplasia show progressive expansion of osteolytic lesions and increasing bony sclerosis. In this disease, bone forms abnormally because of problems with the differentiation and maturation of osteoblasts. Skeletal lesions of the humerus, skull, facial bones, pelvis, and femurs were first detected when the patient was two years old. At 10 years of age, he had a pathologic fracture of the right femur. At the time of the most recent radiograph, the patient was being treated with supplemental calcium phosphate and vitamin D, as well as alendronate and calcitonin, and was asymptomatic. He had never had hyperpigmentation of the skin or endocrine dysfunction indicative of the McCune–Albright syndrome, and no other family members had skeletal lesions.
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