Delayed Diagnosis of a Rare Case of Melorheostosis Affecting Both Upper Limbs

Melorheostosis is an uncommon sclerosing bone dysplasia that primarily affects the long bones on one side, and occasionally hands or feet. The unique radiographic appearance, resembling dripping candle wax on the affected bone, is typically used to aid in diagnosis. We present a case report of a 35-year-old woman who had had several bony swellings in her right hand, right forearm, right arm, left hand, and right upper chest for 28 years, which were slowly progressive. The patient complained of dull, throbbing pain and restricted joint movement in the affected areas. Plain radiography revealed flowing hyperostosis, resembling dripping candle wax, involving multiple bones of both upper limbs, including the right scapula and clavicle. We diagnosed her as a case of melorheostosis involving both upper limbs. She was treated with zoledronic acid, non-steroidal anti-inflammatory drugs (NSAIDs), duloxetine, pregabalin, and ongoing calcium and Vitamin D supplementation. Subsequent follow-up visits at 3, 6, and 12 months showed improvement in pain, with a halt to the progression of swelling.