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Melorheostosis in the upper extremity.
Cengiz Yildirim1, Selahattin Ozyürek, Engin Ilker Ciçek
1Orthopedics and Traumatology, Ankara Mevki Military Hospital, Diskapi, Ankara, Turkey.
Orthopedics
|April 25, 2009
Summary
Melorheostosis, a rare bone disorder, caused significant sclerotic changes in a young man's right upper extremity. Imaging confirmed the "dripping candle wax" appearance, leading to a conservative management approach.
Area of Science:
- Orthopedics
- Radiology
- Medical Imaging
Background:
- Melorheostosis is a rare mesodermal disease characterized by flowing hyperostosis, often incidentally found on radiographs.
- The condition affects the skeleton and adjacent soft tissues, typically presenting with a 'dripping candle wax' radiographic appearance.
Observation:
- A 22-year-old male presented with a two-year history of right-hand pain.
- Radiographic and CT imaging revealed extensive sclerotic changes in the right upper extremity, including metacarpals, phalanges, scapula, humerus, radius, and scaphoid.
- A characteristic 'dripping candle wax' appearance was noted on CT scans.
Findings:
- Radionuclide bone scintigraphy demonstrated diffuse radiotracer uptake throughout the affected right upper extremity.
- Diagnosis of melorheostosis was confirmed based on characteristic imaging features and distribution.
- Conservative management was initiated for the patient.
Implications:
- The case highlights the diagnostic utility of combined radiographic, CT, and bone scintigraphy in melorheostosis.
- Conservative treatment appears effective for managing symptoms in the long term.
- Further research into melorheostosis pathogenesis and treatment options is warranted.
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