“Dripping wax” appearance

Case contribution: Dr. Radhiana Hassan


  • A 30 years old female
  • Painful swelling at little finger for 10 years.
  • No history of trauma
  • No fever or constitutional symptoms

X-Ray findings:

  • Dense continuous cortical thickening involving the 4th and 5th metacarpals and phalanges (yellow arrows)
  • Thick undulating edges giving rise to ‘dripping wax’ appearance
  • No fracture of visualized bones.
  • No joint space narrowing
  • Carpals bones are normal

Diagnosis: Melorheostosis


  • Melorheostosis is a rare chronic bone disorder
  • It manifests as region of sclerosing bone with characteristic appearance known as dripping wax appearance or flowing candle wax appearance
  • It can be either monostotic or polyostotic and tends to be monomelic
  • It usually affects long bones of the limbs, but any bones can be affected
  • Hands and feets are not infrequently involved
  • Involvement of the axial skeleton is rare.
  • THis condition has tendency to involve a sclerotome distribution
  • Associated changes that can be seen include thickening and fibrosis of underlying skin, hyperpigemntation of overlying skin, muscle atrophy, vascular tumours and malformation, other tumours
Author: radhianahassan