McCune-Albright's syndrome: hand with normal for comparison.
This PA film (a) of the hand of a six-year-old girl with skin pigmentation and precocious puberty shows the characteristic appearances of polyostotic fibrous dysplasia. Both bone replacement and new bone formation are evident. The affected spongiosa has an amorphous appearance resembling that of 'ground glass' and the bones show areas of expansion with thinning of the overlying cortex. Small cyst-like lesions are also present with reactive sclerosis around some of their margins. The carpal bones and secondary epiphyses are well developed and the pisiform bone, which normally starts to ossify at about nine years in the female, is seen superimposed on the triquetral. The bone age is advanced to ten years and this film should be compared with (b), that of a normal six-year- old girl, which shows the degree of bony development which usually occurs by that age.
