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Case of the Week 358

What's the most likely diagnosis?

  • 60 year-old male with pain in finger

Frontal radiograph of hand

  1. Avascular necrosis
  2. Tuberculosis
  3. Melorheostosis
  4. Sickle cell disease
  5. Gout

Additional Image - Oblique radiograph of hand


Additional Image


Oblique radiograph of hand




3. Melorheostosis



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General Considerations

  • One of a group of sclerosing bone disorders
  • Rare
  • Cause is unknown
  • Produces thickening of the endosteum and periosteum
  • Peak age of presentation is 5-20 years
  • May be monostotic or polyostotic
    • May involve one entire limb
      • Usually does not involve multiple limbs
  • Twice as common in lower extremities than elsewhere


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