Case contribution: Dr. Radhiana Hassan
Clinical:
- 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
Discussion:
- 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
