Caffey disease or infantile cortical hyperostosis a largely self-limiting disorder which affects infants. It causes bone changes, soft-tissue swelling, and irritability.
Children usually present within first six months with swelling, erythema and irritability.
The exact aetiology is not well known - both familial and sporadic forms appear infrequently.
The mandible, ulna and clavicle are most common sites. Other long bones, ribs, scapula and skull, may also be rarely involved.
Erythrocyte sedimentation rate (ESR) and alkaline phosphatase (ALP) levels are often elevated. The combination of clinical picture and the lab findings along with imaging findings can clinch the diagnosis.
May show lamellated periosteal reactions along with soft tissue swelling. Classic picture involves the ulna, clavicle or mandible. Over a period, the bone remodels itself and normal picture returns.
May show the periostitis with soft tissue oedema. At times MR may give confusing appearances and can lead the radiologist to give an alternate diagnosis. Hence radiography should be the primary modality of investigation and follow up.
Can depict the periostitis and soft tissue oedema. It can illustrate the changes antenatally also.
History and etymology
Caffey first described infantile cortical hyperostosis, hence known as Caffey disease in 1945.
- non-accidental injury
- hypervitaminosis A
- prostaglandin E1 and E2 administration
- infection (including syphilis)
- metastatic neuroblastoma
Other diseases can usually be excluded based on the narrow age range for presentation of infantile cortical hyperostosis; the triad of irritability, swelling, and bone lesions; and the presence of mandibular involvement.