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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.
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.