A rare case of ribbing disease of the proximal tibia
Keywords:Ribbing, Tibia, Sclerosis, Pain
Ribbing disease is a rare disease that causes bony growths to develop in long bones mostly the lower limbs. It often develops after puberty. The disease also goes by other names like multiple diaphyseal sclerosis. The disorder is caused by discrepancy in the osteoclast regulation process. Here in we report a 28 years old male presenting with a case of ribbing disease of right proximal tibia. A 28 years old male gives history of fall when he was 6 years old i. e., 22 years back. Now patient complaints of pain in right proximal tibia since last 6 months. Pain is of mild nature. It is most likely a case of ribbing disease based on the clinical, radiological findings. Ribbing disease is a disease of exclusion, needs high degree of suspicion for its diagnosis. However, patient should be advised for regular follow ups.
Seeger LL, Hewel KC, Yao L, Gold RH, Mirra JM, Chandnani VP et al. Ribbing disease (multiple diaphyseal sclerosis): Imaging and differential diagnosis. AJR Am J Roentgen. 1996;167:689-94.
Makita Y, Nishimura G, Ikegaw S, Ishii T, Ito Y, Okuno A. Intrafamilial phenotypic variability in Engelmann disease (ED): Are ED and Ribbing disease the same entity? Am J Med Genet. 2000;91:153-6.
Mari C, Catafau A, Carrio I. Bone scintigraphy and metabolic disorders. Q J Nucl Med. 1999;43:259-67.
Inaoka T, Shuke N, Sato J, Ishikawa Y, Takahashi K, Aburano T et al. Scintigraphic evaluation of pamidronate and corticosteroid therapy in a patient with progressive diaphyseal dysplasia (Camurati-Engelmann disease) Clin Nucl Med. 2001;26:680-2.
Reinus WR, Fischer KC, Ritter JH. Painful transient tibial edema. Radiology. 1994;192:195-9.
Bettini G, Bonvi V. Etiopathogenetic, clinical, and radiographic considerations on Ribbing's disease: Report of 2 cases of familial nature. Arch Putti. 1962;16:58-72.
Chanchairujira K, Chung CB, Lai YM, Haghighi P, Resnick D. Intramedullary osteosclerosis: Imaging features in nine patients. Radiology. 2001;220:225-30.
Felson DT, Chaisson CE, Hill CL, Totterman SM, Gale ME, Skinner KM et al. The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med. 2001;134:541-9.
Ziran N, Hill S, Wright ME, Kovacs J, Robey PG, Wientroub S. Ribbing disease: Radiographic and biochemical characterization, lack of response to pamidronate. Skeletal Radiol. 2002;31:714-9.
Chapurlat RD, Meunier PJ. Fibrous dysplasia of bone. Baillieres Best Pract Res Clin Rheumatol. 2000;14:385-98
Abdul-Karim FW, Carter JR. Makley JT. Intra-medullary osteosclerosis: report of the clinicopathologic features of five cases. Orthopedics. 1988;11:1667-75.
Shier CK, Krasicky GA. Ellis B. Kottamasu SR. Ribbing’s disease: radiographic-scintigraphic correlation and comparative analysis with Engel- Mann’s disease. J Noel Med. 1987;28:244-8.