Abstract
A 48-year old male patient of Arabic origin presented to the orthopedic consultation with a history of slow progressive pain, joint stiffness and swelling of the left foot. Local tenderness was present and a painful, hard mass was clearly palpable. Conventional radiography (Fig. A) revealed undulating and sclerotic enlarged areas (candle wax-appearance) in the lateral cuneiform bone, the third metatarsal bone and the proximal, intermediate and distal phalanx bone of the third row. Cortical hyperostosis was also apparent in the middle phalanx and metatarsal bone of the second row. Areas of extraosseous bone formation could be seen, most clearly adjacent to the metatarsal head and the middle phalanx of the third row. A diagnosis of melorheostosis was made. A CT-scan, which is not strictly required to make the diagnosis, confirmed the radiographic findings (Fig. B). The patient was treated conservatively.