Melorheostosis in left tibia

Case contributed by Dr Mohamed Hossam el Deen

Presentation

Incidental finding in X ray after complain of both knee joint pain more with mechanical movements.

Patient Data

Age: 40-45
Gender: Male
X-ray

There is cortically based endosteal regional sclerosis in the medial aspect of proximal left tibia with characteristic candle wax appearance. 

MRI

There is cortical based regional area of signal intensity iso intense to the bone cortex of proximal left tibia with characteristic candle wax appearance more apparent on  coronal T1 and sagittal T2 sequences.  

Case Discussion

Melorheostosis can be either monostotic or polyostotic, and tends to be monomelic as it follows a sclerotomal distribution. It has a predilection for long bones of the limbs, although it can be seen almost anywhere. Hands and feet are not infrequently involved, whereas involvement of the axial skeleton is rare. Typically, melhorheostosis is periosteal not endosteal, and therefore this could represent a healed (ossified) non-ossifying fibroma as well, but is more dense than would be expected with a healed NOF. 

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Case information

rID: 52821
Case created: 21st Apr 2017
Last edited: 22nd Jun 2017
Inclusion in quiz mode: Included

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