Polyostotic melorheostosis

Case contributed by Dr Matt Skalski

Presentation

Ride sided lower extremity pain. Palpable bump on the tibia.

Patient Data

Age: Adult
Gender: Female
Modality: X-ray

Multiple linear areas of sclerosis are present involving the distal tibia and first ray oriented along the long axis of these bones, with undulating cortical thickening most prominently along the anterior tibia and medial 1st metatarsal. 

Modality: X-ray

The anterior tibial cortex is thickened, with and undulating contour along the periosteal surface of the anterior cortex giving a "dripping candle wax" appearance. Linear areas of sclerosis are present within the proximal and distal metaphyses, oriented along the long-axis of the tibia. The patella and distal femur appear to have similar findings. 

Modality: X-ray

There is cortical thickening of the right iliac crest and anterior surface, as well as along the acetabular roof.  Linear areas of sclerosis are present subject to this.  The right proximal femur also has a thick sclerotic cortex medially with scattered areas of medullary sclerosis. 

Case Discussion

Typical case of polyostotic melorheostosis following a sclerotomal distribution, with the characteristic "dripping candle wax" appearance of the thickened cortex along the periosteal surface of involved sites. 

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Case Information

rID: 45688
Case created: 3rd Jun 2016
Last edited: 5th Jun 2016
Inclusion in quiz mode: Included

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