Abstract
Background
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.
Objective
This case report describes a patient who presented to the Emergency Department (ED)
with this rare disease in an uncommonly affected bone.
Case Report
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.
Conclusion
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.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Emergency MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- 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
Article info
Publication history
Published online: June 25, 2010
Accepted:
May 2,
2010
Received:
December 4,
2009
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
