Adeyomoye A A O, Awosanya G O G, Arogundade R A
Department of Radiation Biology, Radiotherapy and Radiodiagnosis,College of Medicine, University of Lagos.
Niger Postgrad Med J. 2004 Sep;11(3):234-6.
Melorheostosis of Leri is a non-familial condition of hyperostosis of the cortical bone that usually presents unilaterally in long bones of the upper and lower limbs, but may also present in vertebra, ribs, skull and jaw. The incidence of this disease is quite rare, only about 300 cases have been reported worldwide. We present a case, which may be the first documented case in sub-Saharan Africa.
S.K. is a 14 year old male student who presented to the hospital with an 18 month history of persistent pain in the joints of the right upper limb and a limb length discrepancy since birth which has worsened with growth. Examination revealed generalised hypoplasia of the right upper limb with shortening of the limb and atrophy of the muscles, also hypoplasia and contracture of the thumb was observed. The radiographs of the limb showed multiple areas of dense hyperostosis and scleroderma, which showed a linear distribution along the radial half of the bones.
In children presentation of melorheostosis, is more likely be as limb length discrepancy, deformity or joint contractures which may be seen before radiographic evidence of any bony changes. Improvement in imaging techniques will therefore result in early diagnosis and greater success with conservative management. Also the increased frequency of tumours necessitates long-term follow up.
melorheostosis, scleroderma.
勒里骨肥大症是一种非家族性的皮质骨骨质增生疾病,通常单侧出现在上肢和下肢的长骨中,但也可能出现在椎骨、肋骨、颅骨和颌骨中。这种疾病的发病率相当罕见,全球仅报道了约300例。我们报告了一例,这可能是撒哈拉以南非洲地区首例有记录的病例。
S.K.是一名14岁的男学生,因右上肢关节持续疼痛18个月,且自出生以来肢体长度不等,随生长而加重,前来医院就诊。检查发现右上肢普遍发育不全,肢体缩短,肌肉萎缩,还观察到拇指发育不全和挛缩。该肢体的X线片显示多处致密性骨质增生和硬皮病,沿骨骼桡侧呈线性分布。
在儿童中,骨肥大症的表现更可能是肢体长度不等、畸形或关节挛缩,这些可能在任何骨质改变的影像学证据出现之前就可见到。因此,成像技术的改进将有助于早期诊断,并在保守治疗中取得更大成功。此外,肿瘤发生率的增加需要长期随访。
骨肥大症;硬皮病