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Case Reports
. 2020 Dec;10(9):94-97.
doi: 10.13107/jocr.2020.v10.i09.1918.

Dripping Wax Bone Disease - Melorheostosis - A Rare Case Scenario

M Lokesh  1 , Muthumanickam  1 , Sundar Suriya Kumar  1 , Saikrishna Gadde  2
Affiliations
Case Reports

Dripping Wax Bone Disease - Melorheostosis - A Rare Case Scenario

M Lokesh et al. J Orthop Case Rep. 2020 Dec.

Abstract

Introduction: Melorheostosis is a rare condition affecting the bones and has only been occasionally reported. We herein report a case of melorheostosis affecting left femur and tibia which was diagnosed based on clinical and radiological features and managed with bisphosphonates.

Case report: A 28-year-old female patient presented with complaints of pain over left knee and thigh for the past 3 months. To evaluate the cause of pain X-ray and magnetic resonance imaging were done, which revealed characteristic candle dripping wax appearance suggestive of melorheostosis. After arriving at the diagnosis patient was started on nonsteroidal anti-inflammatory drugs and pamidronate which provided symptomatic betterment patient has now been followed up for past 1 year and is symptom free.

Conclusion: Melorheostosis is an uncommon cause of a common symptom. Positive clinical and imaging features helped us to arrive at the diagnosis. Proper work up would help in early diagnosis and management. More evidence is needed to illustrate the effectiveness of medical or surgical treatments for patients with this rare diagnosis.

Keywords: Candle dripping wax; melorheostosis; pamidronate.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
Clinical picture of patient showing muscle wasting of affected limb (a) and full range of motion of the left knee (b).
Figure 2
Figure 2
Anteroposterior radiograph of the left knee with leg shows characteristic candle dripping wax appearance predominantly involving the medial aspect of the shaft of tibia and medial tibial and femoral condyle.
Figure 3
Figure 3
Anteroposterior and lateral radiograph of the left femur shows cortical and medullary hyperostosis at the subtrochanteric region.
Figure 4
Figure 4
Coronal stir (a), coronal T1 (b), Axial T2 (c) images – show low signal intensity involving the diaphysis in the medial aspect and medial tibial condyle suggestive of endosteal thickening with sclerosis.
Figure 5
Figure 5
Coronal t1(a) stir(b) sequences of left femur show low signal in the proximal diaphysis suggestive of sclerosis involving the medial and lateral aspect causing medullary narrowing.
See this image and copyright information in PMC

References

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