A Unique Case of Melorheostosis Presenting with Two Radiologically Distinct Lesions in the Shoulder

Elsheikh, Ahmed; Pinto, Rohan Sebastian; Mistry, Alpesh; Frostick, Simon P.

doi:10.1155/2017/9307259

Cited by 8 publications

(9 citation statements)

References 26 publications

(78 reference statements)

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“…( 34,36–39 ) For example, CT commonly identifies intramedullary canal narrowing, which can result in pain. ( 32,38,40,41 ) Consistent with these reports, we noted the extension of melorheostotic lesions into ischiofemoral space, notably on the right side in all four patients, in the context of ischiofemoral impingement syndrome‐like symptoms, such as deep gluteal and/or hip pain. Furthermore, in patients in whom surgical management is being considered, CT is necessary for preoperative planning.…”

Section: Discussionsupporting

confidence: 87%

Cross‐Sectional Imaging Useful in Melorheostosis

et al. 2021

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Melorheostosis is a rare disease of bone overgrowth that is primarily diagnosed based on imaging studies. Recently, the association of different radiological patterns of the disease with distinct genetic cause was reported. Several case reports have described the radiological findings in patients with melorheostosis. However, the added value of cross-sectional imaging with CT and MRI beyond X-rays has not been investigated. The aim of the current study was to investigate this existing gap in knowledge. Forty patients with melorheostosis seen at the National Institute of Health Clinical Center were included in the study, and all their imaging studies were analyzed. The sequence of interpretation was X-ray followed by CT and then MRI. CT images were extracted from whole-body 18Fsodium fluoride positron emission tomography/CT studies. The information from CT reclassified the initial X-rays based radiological pattern in 13 patients. Additionally, CT comprehensively identified joint involvement and disease extent. In 76% of patients (n = 29) who underwent MRI, additional findings were noted, ranging from soft tissue edema to identification of soft tissue masses and incidental findings. MRI did not provide additional information on skeletal lesions beyond CT scans. However, it revealed the extension of soft tissue ossification into ischiofemoral space in four patients who complained of deep gluteal pain consistent with ischiofemoral impingement syndrome. In addition, MRI revealed soft tissue edema in 20 patients, 9 of whom had bone marrow edema and periosteal edema in the tibias consistent with shin splints. These findings suggest that select patients with melorheostosis should be evaluated with both CT and MRI, particularly patients in whom the distribution of pain does not correlate with the anatomic location of the disease in plain radiographs.

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Section: Discussionsupporting

confidence: 87%

Cross‐Sectional Imaging Useful in Melorheostosis

et al. 2021

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“…Diagnosis of melorheostosis may be confirmed by radiological studies such as X-rays, CT, MRI, and bone scan [15]. Bone scintigraphy, MRI, or CT is helpful and was found to delineate the severity of the illness and help the physician to operate better [16].…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Melorheostosis in the Hand of a Saudi Woman

Abed

Mashrah

Almahdaly

et al. 2020

Cureus

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Melorheostosis is a very rare bone dysplasia, especially in the hand. Most cases were diagnosed incidentally, with the lower limbs being the most affected. This is the first Saudi woman with hand melorheostosis. A 33-year-old Saudi female had mild to moderate right-hand pain that started six years ago. Hand examination showed a full range of motion and full hand grip, and there was no tenderness upon palpation. Plain X-ray, unenhanced CT scan, and MRI of the hand showed an appearance resembling dripping candle wax as melorheostosis. The bone scan showed a nonvascular and nonacute lesion. An unenhanced CT scan demonstrated cortical and endosteal hyperostosis involving the proximal, middle, and distal third and fourth phalanges. Multisequential MRI of the hand demonstrated cortical hyperostosis involving the ulnar and radial aspect of the right fourth proximal, middle, and distal phalanges. Features in the X-ray, CT scan, bone scan, and MRI confirmed a diagnosis of melorheostosis with associated flexor tenosynovitis.

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“…Melorheostosis was described for the first time in 1922 by Leri and Joanny [ 7 ]. Melorheostosis typically begins in an insidious manner, with slow progression over time.…”

Section: Discussionmentioning

confidence: 99%

“…Elsheikh et al [ 7 ] described the case of a 51 yr old male that presented with a painful swelling on the right shoulder. The patient had no history of trauma and the pain was progressive in nature.…”

Section: Discussionmentioning

confidence: 99%

Debridement arthroplasty of a rare case of elbow stiffness. A case report and literature review

Poonit

Yao

Zhou

et al. 2018

International Journal of Surgery Case Reports

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HighlightsMelorheostosis of the elbow associated with elbow stiffness is extremely rare.In the standard radiology or orthopedics literature Melorheostosis (from the Greek: melos = limb, rheos = flow) is described monotonously as a “flowing hyperostosis” resembling dripping candle wax.Patients with this condition may have joint pain, stiffness, deformity, and restricted range of motion due to bony and soft-tissue contracture. Involvement usually follows a sclerotomal distribution and usually affects only one extremity.There is no standard treatment for melorheostosis, and management plans must be made on an individual patient basis. The aims of treatment are pain relief and maintaining function.Some Surgical treatment for this condition includes tendon lengthening, excision of fibrous and osseous tissue, fasciotomy, capsulotomy, sympathectomy, corrective osteotomy, Ilizarov lengthening, arthrodesis, implant arthroplasty, and even amputation of severely affected limbs with vascular ischemia.In this study we found that debridement arthroplasty is safe and effective in treating elbow stiffness associated with Melorheostosis.

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A Unique Case of Melorheostosis Presenting with Two Radiologically Distinct Lesions in the Shoulder

Cited by 8 publications

References 26 publications

Cross‐Sectional Imaging Useful in Melorheostosis

Cross‐Sectional Imaging Useful in Melorheostosis

A Rare Case of Melorheostosis in the Hand of a Saudi Woman

Debridement arthroplasty of a rare case of elbow stiffness. A case report and literature review

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