ISPUB.COM The Internet Journal of Orthopedic Surgery Volume 4 Number 2 1 of 4 Melorheostosis - Scintigraphic And Histopathological Features: A Case Report J Hephzibah, B Theodore, R Oommen, V Cherian, A Eapen, A Deepti Citation J Hephzibah, B Theodore, R Oommen, V Cherian, A Eapen, A Deepti. Melorheostosis - Scintigraphic And Histopathological Features: A Case Report. The Internet Journal of Orthopedic Surgery. 2006 Volume 4 Number 2. Abstract Melorheostosis is a rare bone disorder of unknown etiology with linear hyperostosis. We describe the scintigraphic, radiologic and histopathological findings in a 40 year old gentleman who presented with pain and swelling in the left knee. Scintigraphic appearance is characteristic, with asymmetric cortical activity that may cross joints to involve contiguous bones. Bone scintigraphy eliminates the need for multiple radiological images. Histology shows marked endosteal sclerosis with marrow fibrosis consistent with melorheostosis CASE REPORT A 40-year-old gentleman was evaluated for pain and swelling in the left knee with difficulty in walking. Plain radiographs of pelvis and left lower limb showed peripherally located hyperostosis with ‘flowing candle wax dripping ‘ appearance in left hip and bones of left lower limb, suggestive of melorheostosis (Fig. 1-4). Figure 1 Figure 1-4: Plain radiographs of pelvis and left lower limb showing peripherally located hyperostosis with ‘flowing candle wax dripping ‘ appearance - features suggestive of melorheostosis Bone scintigraphy with Tc99m methylene diphosphonate (MDP) revealed abnormal increase in radionuclide uptake and asymmetric cortical activity along the cortex of entire length of left femur, left tibia, left tarsal and metatarsal bones. The activity was found to be crossing the left hip and knee joints (Fig. 5). Histopathological examination of the lesion from femur showed marked endosteal sclerosis with