Acroosteolysis, which is sometimes known as acro-osteolysis, is a rare condition that results in the loss of bone and tissue in the fingers and toes. In most cases, this condition is inherited, though it can also result from overexposure to polyvinyl chloride (PVC) or a severe case of frostbite. Patients with this condition often lose tissue because once the acroosteolysis begins to destroy the bones, the ends of the fingers and toes must be surgically removed so that nearby tissue is not damaged. Some diseases can also result in the loss of bone tissue at the ends of the digits.
In humans, the bone at the tip of each finger or toe ends with a structure known as a tuft. These tufts are a wider, flatter part of the bone and they are found on the ends of bones known as the distal phalanges. In acroosteolysis, these tufts disintegrate, leading to permanent damage of the fingers and toes. This damage occurs slowly and may be difficult to diagnose in time to treat. Left untreated, the loss of bone causes the the surrounding tissue to die.
While it may be difficult for patients to determine whether damage to the ends of the bones is occurring beneath the skin on the fingers and toes, there are a few external symptoms of acroosteolysis. Ulcers may form on the tips of the fingers and toes in patients with this condition. In many cases, these ulcers may not heal or may heal and reappear frequently. The tissue at the ends of the digits may also recede in acroosteolysis, causing the fingers and toes to shorten irregularly.
In order to test for acroosteolysis, doctors will need to examine the density of the bones in the hands and feet. Blood tests can be used to determine whether calcium is being leached from the bones. X-rays and magnetic resonance images (MRIs) can also be taken so that doctors can see if there has been any damage to the bones.
There is no treatment for acroosteolysis. When the condition is discovered, amputation may need to be performed in order to prevent the spread of tissue necrosis and painful ulceration on the affected digits. In some cases, acroosteolysis that is caused by another medical condition can be treated through the management of this disorder.
Doctors are not sure exactly why acroosteolysis occurs, though they have identified a number of conditions that can lead to it. Exposure to extreme hot or cold can physically damage the bones at the end of the digits, and longterm exposure to certain plastics can also cause irreversible damage. Hyperparathyroidism, leprosy, and hereditary sensory and autonomic neuropathy can also lead to this condition.
