Bone Abstracts

Bacground: Melorheostosis is a rare, non-familial and progressive disorder characterized by hyperostosis, of the cortical bone. Typical clinical symptoms include chronic pain, limitation of joint movement,and soft tissue ossification and hand or foot deformity. Radiographic findings are helpful in the diagnosis, these consist of irregular hyperostosis extending along the length of one side of the long bone,resembling flowing candle wax. Medications including non-steroid anti-inflammatory drugs,nifedipine and high dose bisphosphonates are usually used for pain control. Here, we reported a case with melorheostosis whose pain control was abated temporarly by several drugs including local anastethics but fully stopped by daily walking only.

Presenting Problem and Clinical management: A 16 years- old female had chronic hard pain around her foots and hands, and had been hurt in shoe gear. The physical exam revealed a severely ‘C’ shaped right and left foots that was nonreducible, and erythematous change, callosity formation were seen around the contact area between the skin and the shoes. Biochemical findings were within the normal range. Radiological examination showed that distal part of the ulna and metacarpal and carpal phalanges 3–4 and metatarsal phalanges were thickened and sclerosed. She was treated with high dose sodium pamidronate (1 mg/kg per day,3 days each 3 mounts) for 9 mounts. At the end of this period, swelling in her hands and foots decreased and the pain abated, but when biphospanate treatment was stopped, severe bone pain on her legs and arms began again. She was taking local anasthetics from time to time. After then, we recommended her to walk 45 minutes twice in a day only. After she began daily walking program,her pain disappeared in 2 mounts. She has been going on daily walking for one year, so she has no pain and restriction of extremities.

Conclusion: Treatment options are limited in melorheostosis.Non steroid antiinflamatuvar drugs, nifedipine and even sympathetic blockers have been prescribed to alleviate pain. Here, we observed that severe pain can be treated by daily walking program without taking any drugs in melorheostosis.

Disclosure: The authors declared no competing interests.