Indian Journal of Radiology and Imaging Indian Journal of Radiology and Imaging

: 2001  |  Volume : 11  |  Issue : 1  |  Page : 35--36

Radiological quiz - musculoskeletal

I Rajapandian, A Jeyaraman, S Rajamohan, A Swaminathan, MK Sivakolunthu 
 Department of Radiology and Cancer Govt. Rajaji Hospital, Madurai Medical College, Madurai-625020, India

Correspondence Address:
I Rajapandian
Department of Radiology and Cancer Govt. Rajaji Hospital, Madurai Medical College, Madurai-625020

How to cite this article:
Rajapandian I, Jeyaraman A, Rajamohan S, Swaminathan A, Sivakolunthu M K. Radiological quiz - musculoskeletal.Indian J Radiol Imaging 2001;11:35-36

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Rajapandian I, Jeyaraman A, Rajamohan S, Swaminathan A, Sivakolunthu M K. Radiological quiz - musculoskeletal. Indian J Radiol Imaging [serial online] 2001 [cited 2019 Sep 20 ];11:35-36
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A twenty seven years old woman has come to the hospital with complaints of swelling, pain and restriction of movements in the right little and ring fingers and in the right elbow for the past one year. The radiographs of the patient's right hand and forearm were obtained [Figure 1],[Figure 2].

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The radiographs showed irregular dense cortical hyperostosis involving the phalanges and metacarpals of fourth and fifth fingers and carpal bones on ulnar aspect [Figure 1], and also the medial aspect of ulna and lower end of humerus [Figure 2].

Melorheostosis is an unusual sclerosing bone dysplasia of unknown etiology, which may be associated with soft tissue changes. this condition was first reported by Leri in 1922, and since then more than thirty cases have been reported. [1],[2]. Distinguishing features as - changes are confined to one limb, outline of the affected bone is definitely distorted, presence of pain, limitation of movements in the joints formed by the affected bones.

Radiologically the condition is characterised by irregular undulating cortical hyperostosis usually involving the long bones especially of the lower limbs. Involvement of the skull, spine and ribs is ususual. These densities have a peculiar sclerotomal distribution representing the zones of skeleton supplied by individual spinal sensory nerves. [3],[4]. Kraft (1933) distinguished three types of the disease [1]

A whole extremity is affected, and the dense cortical proliferations appear to flow as a regular continuous flow from shoulder to finger or hip to foot. Only half of the extremity, usually the proximal half is affected. A whole extremity is irregularly involved and there are multiple interruption of flow.

During growth the deformities usually progress rapidly but in adult life the progression is slow. Premature epiphyseal fusion may result in shortening of the affected limb.

Booone scan complements standard radiological studies and permits evaluation of the extend and activity of disease

There is no speficic treatment for this condition[5]


1Robery.B.Duthie and Roger Smith. Developmental diseases of the skeleton in: Mercer,eds.Mercer's Textbook of Orthopaedic Surgery;9th ed.London: Arnold, 1996:276-277
2Craniofacial and humeral melorheostosis; Tueche sg, Gebhart M, Dewolf J, Baillon JM, Limbosch JM; Acta chir belg 1999 Feb: 99(1): 47-50.
3Murray RO, Mcredie J, Melorheostosis and the sclerotomes: A radiological correlation.skeletal radiology 1979 June 6;4(2);52-71.
4Sharma R, Burke FD;Melorheostosis of hand;Journal of hand surgery (Br) 1996 June; 21(3);413-415.
5Takeda T,ogura N,Jodo S,et al; A case of melorheostosis with linear sclerodermatous skin changes; Ryumachi 1995 June: 35 (3): 580-584