Polyostotic Melorheostosis: Approach to Clinical Evaluation and Management

Chee Chien Teoh,David Chen Hol Chieng,Xi Yuan Ang,Shawn Ru Zye Teoh,Mohamad Hafiz Mohmad Hassim

doi:10.4236/ojo.2019.97014

Abstract

Melorheostosis is a rare form of sclerosing bone dysplasia that involves mainly the long bone of the limbs. However, the involvement of more than one long bone, either involving ipsilaterally or contralaterally, is extremely rare. The aetiology still remains unknown despite approximately 400 cases have been reported in the literature up to date. Diagnosis is mainly by conventional radiographic imaging such as plain X-ray, in which the typical melting wax dripping down a candle appearance is seen. The main treatment options are conservative management involving mainly analgesias, physiotherapy, braces, and possible nerve block and symphathectomies if indicated. The aim of this case report is to discuss the approach to a case of melorheostosis involving two long bones of the ipsilateral lower limb (polyostotic) that presented to us in our centre. Appropriate investigations and treatment modalities must be tailored according to the patient’s complaints in order to achieve satisfactory treatment outcomes. With adequate analgesia complimenting with appropriate physiotherapy and rehabilitation, our patient’s symptoms improved dramatically.

Highlights

Melorheostosis is a rare form of sclerosing bone dysplasia that involves mainly the long bone of the limbs
First described in 1922 by Leri and Joanny, it is a benign bone disorder exhibiting patterns of hyperostosis characterised by linear distribution along the major axis of long bones, resembling a “dripping candle wax” appearance [2]
Melorheostosis is a rare connective tissue disease characterized by sclerosing bone dysplasia

Summary

Introduction

Melorheostosis (synonyms: candle bone disease, melting wax syndrome, Leri disease) is an atypical, non-hereditary, sclerosing bone dysplasia that affects both. It mainly affects the long bone of the limbs, and involvement of more than one long bone is rare. First described in 1922 by Leri and Joanny, it is a benign bone disorder exhibiting patterns of hyperostosis characterised by linear distribution along the major axis of long bones, resembling a “dripping candle wax” appearance [2]. It has equal distribution among men and women [3], which usually presents after early childhood or adolescence [4]. The patient agreed to participate in this case report by means of a free and informed consent form

Case Report

Discussion

Conclusion