Melorheostosis of foot and ankle

NewsBot · Aug 18, 2012

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Three cases of melorheostosis with foot and ankle involvement.
Pino AE, Temple HT.
Am J Orthop (Belle Mead NJ). 2012 Aug;41(8):E115-9.

Melorheostosis is a rare and poorly understood condition of bone and soft tissue with a wide range of clinical presentations. This condition is typically characterized by cortical hyperostosis and pain in the involved extremity, but can also be associated with soft-tissue masses and limb deformities that may be additional sources of disability for those affected by this disease. Characteristic radiographic findings can aid in establishing an accurate diagnosis and the condition should not be mistaken for more aggressive neoplasms. This chronic condition is typically managed nonoperatively, but more invasive measures may be necessary when nonoperative measures fail. In cases of surgical intervention, physicians and patients should be aware that this disease has a high recurrence rate. Although there are only a few reports of melorheostosis in the foot and ankle, it is important to be aware of the difficulties the condition may cause in this anatomical location. Melorheostosis can be a source of significant morbidity when the foot and ankle are involved, especially when complicated by symptomatic soft-tissue masses. In this article, we report 3 cases of melorheostosis in the foot and ankle with distinct presentations and variations in outcomes.
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NewsBot · Aug 18, 2012

Re: Melorheostosis with foot and ankle

Melorheostosis

Medical condition

Melorheostosis is a medical developmental disorder and mesenchymal dysplasia in which the bony cortex widens and becomes hyperdense in a sclerotomal distribution. The condition begins in childhood and is characterized by thickening of the bones. Pain is a frequent symptom and the bone can have the appearance of dripping candle wax.^[1]

^ "Definition of Melorheostosis". Medicinenet.com. Archived from the original on 10 September 2017. Retrieved 9 July 2018.

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NewsBot · May 16, 2013

Appearance of Osteolysis with Melorheostosis: Redefining the Disease or a New Disorder? A Novel Case Report with Multimodality Imaging
Lawrence S. Osher, DPM, Marie Mantini Blazer, DPM, Kelly Bumpus, DPM
Journal of Foot and Ankle Surgery Article in Press

We present a case report of melorheostosis with the novel radiographic finding of underlying cortical resorption. A number of radiographic patterns of melorheostosis have been described; however, the combination of new bone formation and resorption of the original cortex appears unique. Although the presence of underlying lysis has been postulated in published studies, direct radiographic evidence of bony resorption in melorheostosis has not been reported. These findings can be subtle and might go unnoticed using standard imaging. An in-depth review of the radiographic features is presented, including multimodality imaging with magnetic resonance imaging and computed tomography.
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NewsBot · Feb 20, 2016

Melorheostosis of the Foot: A Case Report of A rare entity with a Review of Multimodality Imaging Emphasizing the Importance of Conventional Radiography in Diagnosis
Ashish G, Shashikant J, Ajay P, Subhash D.
Journal of Orthopaedic Case Reports 2016 Jan-Mar;6(1): 79-81

Introduction: Melorheostosis is a benign bone dysplasia affecting predominantly the appendicular skeleton and adjoining soft tissues. The diagnosis can be established on plain radiographs alone and advanced imaging modalities can be avoided. We hereby report a rare case of melorheostosis affecting the foot with a review of the role of various imaging modalities in diagnosis of this rare bone dysplasia.
Case Report: We present the case of a 29 years old man who was diagnosed with melorheostosis affecting his left foot. The patient presented to the outpatient department of our tertiary care referral hospital with complains of pain in the left ankle and foot with imaging and evaluation done at a primary center.The radiograph revealed an irregular, longitudinal extraosseous hyperostosis along the body of the calcaneum and the metacarpals which was consistent with the classical radiological description of melorheostosis. The CT, MRI and bone scan findings corroborated our primary diagnosis.
Conclusion: The purpose of this case report is to review the features of this rare disorder affecting the foot, on multiple imaging modalities and emphasizing the role of conventional radiology in its diagnosis.
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NewsBot · Jun 15, 2016

Melorheostosis of the Foot: A Case Report of A rare entity with a Review of Multimodality Imaging Emphasizing the Importance of Conventional Radiography in Diagnosis.
Ashish G et al
J Orthop Case Reports. 2016 Jan-Mar;6(1):79-81. doi: 10.13107/jocr.2250-0685.385.

INTRODUCTION:

Melorheostosis is a benign bone dysplasia affecting predominantly the appendicular skeleton and adjoining soft tissues. The diagnosis can be established on plain radiographs alone and advanced imaging modalities can be avoided. We hereby report a rare case of melorheostosis affecting the foot with a review of the role of various imaging modalities in diagnosis of this rare bone dysplasia.
CASE REPORT:
We present the case of a 29 years old man who was diagnosed with melorheostosis affecting his left foot. The patient presented to the outpatient department of our tertiary care referral hospital with complains of pain in the left ankle and foot with imaging and evaluation done at a primary center. The radiograph revealed an irregular, longitudinal extraosseous hyperostosis along the body of the calcaneum and the metacarpals which was consistent with the classical radiological description of melorheostosis. The CT, MRI and bone scan findings corroborated our primary diagnosis.
CONCLUSION:
The purpose of this case report is to review the features of this rare disorder affecting the foot, on multiple imaging modalities and emphasizing the role of conventional radiology in its diagnosis.
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NewsBot · Jul 30, 2016

Melorheostosis: A Retrospective Clinical Analysis of 24 Patients at an Academic Medical Center
Gabriel C. Smith, MD, Matthew J. Pingree, MD, Laura A. Freeman, MD, Jane M. Matsumoto, MD, Benjamin M. Howe, MD, Stephanie N. Kannas, CHT, OT, Mary D. Pyfferoen, PT, Leah T. Struss, OT, Doris E. Wenger, MD, Kimberly K. Amrami, MD, Martha Matsumoto, MD, Mary L. Jurisson, MD
PM & R;Article in Press

Background
Current understanding of the clinical features of persons with melorheostosis is restricted primarily to individual case reports and small case series.

Objective
To assess the clinical features of patients with melorheostosis treated at our institution from 1972 through 2010.

Design
Chart review.

Setting
Tertiary academic medical center.

Participants
Twenty-three patients with ?definite? and one patient with ?probable? melorheostosis based on radiographic criteria.

Methods
The eligible study cohort was identified through an index database. Further diagnostic confirmation of patients with melorheostosis was performed by radiographic review.

Main Outcome Measurements
We evaluated age at first visit to our institution, gender, affected body area, number of bones affected, presenting symptoms, surgical evaluation, and therapies provided.

Results
Average age of first evaluation at our clinic was 36.5 years (median [range], 41.5 [3-68] years). Female to male ratio was 4:1. The lower extremity was most commonly affected (66.6%), followed by upper extremity (33.3%), spine (16.6%), and head (8.3%). One-third of patients had involvement of a single bone; two-thirds had multiple bone involvement. Pain was the most common presenting concern (83.3%), followed by deformity (54.1%), limitation of movement (45.8%), numbness (37.5%), and weakness (25.0%). Most patients had a physician evaluation (87.5%); patients also underwent orthopedic surgery (45.8%), physical therapy (33.3%), and occupational therapy (12.5%).

Conclusions
Melorheostosis is a rare sclerotic bone disease resulting in pain, deformity, and dysfunction. An interdisciplinary approach to care should include nonoperative and operative evaluation, as well as appropriate therapies. A prospective approach to evaluation, including imaging and physical examinations, would provide valuable longitudinal data.
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NewsBot · Mar 2, 2017

Melorheostosis − Foot and Ankle Perspective
Mandeep Singh Dhillon et al
The Foot; Article in Press

Highlights
•The clinician must be aware regarding the clinical and radiological presentation of this uncommon disorder involving bone and adjacent soft tissues.
•Involvement of the foot and ankle may present with pain, swelling and deformity, with concomitant difficulty in footwear use or engaging in sporting activities.
•The diagnosis is radiological.
•Surgical management is not always required.
•Regular follow up is required to detect disease progression.
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Howellig · Jul 20, 2022

Good afternoon everyone,
Hope you are all going well.
Have a unique case I've never seen before and wondered if anyone had any experience with it.
Shared with patient consent, 5 year old girl, only complaint was left 3rd digit clawing and causing thick toenail. On recent X-ray, sclerotic changes on several bones on left foot only. Radiologist reported potential Melorheostosis. Patient has been referred to an orthopaedic surgeon for opinion and further imaging. In meantime, toe clawing responding well to kinesiology taping using an over and under pattern for toes 2 to 4 'hammock style'. Best wishes, Nicholas

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Melorheostosis

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Howellig Member

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