Melorheostosis is a rare disease that affects fewer than 1:1,000,000 persons worldwide and most typically affects the lower extremities. It is a non-hereditary disease that may be debilitating due to chronic pain, contractures of the soft tissue, and even shortening of the affected limbs. Although it most commonly occurs in the lower extremities, melorheostosis has been reported in various locations throughout the body.
This case report describes a patient who presented to the Emergency Department (ED) with this rare disease in an uncommonly affected bone.
The patient was a 21-year-old man who presented to the ED with pain in his left upper extremity that he attributed to playing sports 3 days before presentation. Plain films revealed periosteal hyperostosis typical of melorheostosis in several of his carpals, metacarpals, and phalanges, as well as the humerus and ulna. The patient was discharged with orthopedic follow-up and pain medication.
Melorheostosis is a rare disease that has characteristic radiographic findings likened to the appearance of melting wax flowing down the side of a candle. In certain cases, the disease can be debilitating and may require chronic pain management and even operative intervention. If this diagnosis is made in the ED, the emergency physician should provide adequate pain management and refer the patient to an orthopedic specialist for a work-up to rule out other sclerosing bone dysplasias.
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- Une affection non decrite des os. Hyperostose “en coulee” sur toute la longeur d'un member ou “melorheostose”.Bull Mem Soc Med Hop Paris. 1922; 46: 1141-1145
- Melorheostosis of the skeletally immature hand: a case report and long-term follow-up.J Hand Surg Am. 1996; 21: 703-706
- Melorheostosis: a review of 23 cases.Eur Radiol. 2001; 11: 474-479
- Melorheostosis and FGF-23: is there a relationship?.Joint Bone Spine. 2008; 75: 486-488
- Melorheostosis: an unusual presentation in the foot.Foot. 1999; 9: 101-103
- A patient with melorheostosis manifesting with features similar to tricho-dento-osseous syndrome: a case report.J Med Case Reports. 2008; 2: 51
- Melorheostosis: report of two cases affecting the jaw.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 104: e66-e70
- Melorheostosis of the hand.J Hand Surg Br. 1996; 21: 413-415
Published online: June 25, 2010
Accepted: May 2, 2010
Received: December 4, 2009
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.