Osteopoikilosis, known as ’spotted bone disease’, is a rare and usually asymptomatic bone disorder but can be associated with malignant bone tumours. We present a patient with type I diabetes and Frozen Shoulder that was diagnosed with osteopoikilosis as an incidental finding when assessed radiographically. The radiographic features of this pathology are highlighted and the investigations described to exclude more sinister pathology. One of the usual diagnostic criteria of Osteopoikilosis is normal alkaline phosphatase blood levels however this is the first report of a patient whose alkaline phosphatase levels were persistently raised. This was attributed to diabetes. Raised alkaline phosphatase levels of an unknown cause have been previously reported to be a common finding in this patient group.