Melorheostosis: segmental osteopoikilosis or a separate entity?

J Pediatr Orthop. 2015 Mar;35(2):e13-7. doi: 10.1097/BPO.0000000000000384.

Abstract

Purpose: Melorheostosis is a progressive hyperostotic bone disease that commonly affects the appendicular skeleton. Melorheostosis has a significant degree of overlap with other hyperostosis conditions including osteopoikilosis and likely represent varying degrees of a clinical spectrum.

Methods: This is a report of 2 patients with melorheostosis who presented with different clinical presentations and involvement of different anatomic locations.

Results: One of the patients presented with foot size asymmetry along with intermittent foot pain and limping. This patient also had irregular nonblanching yellow plaque-like lesion on the forehead. The second patient presented with abnormal gait but no pain. Radiographs demonstrated endosteal hyperostosis, which were consistent with a mixed picture of melorheostosis and osteopoikilois. Genetic testing of the LEMD3 gene from a blood sample was negative in both cases.

Conclusions: The diagnosis of melorheostosis can be made based on the clinical and radiographic features and can be challenging to differentiate from other hyperostosis conditions.

Level of evidence: Level V.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Foot Bones / pathology*
  • Foot* / diagnostic imaging
  • Foot* / growth & development
  • Genetic Testing
  • Humans
  • Male
  • Melorheostosis* / diagnosis
  • Melorheostosis* / etiology
  • Melorheostosis* / physiopathology
  • Melorheostosis* / therapy
  • Muscle Stretching Exercises / methods
  • Organ Size
  • Osteopoikilosis / diagnosis*
  • Postural Balance
  • Radiography