Localised melorheostosis


  • Sunny Agarwal Department of Orthopaedics, 1St Stephen’s Hospital, Tis Hazari, New Delhi, India
  • Vishesh Khanna Fellow in Arthoplasty, Sunshine Hospital, Secunderbad, Telangana, India
  • Mathew Varghese Department of Orthopaedics, 1St Stephen’s Hospital, Tis Hazari, New Delhi, India
  • Suresh B Subbaiah Institute of Medical Sciences, Purle, Shivamogga, Karnataka, India




Localised melorheostosis, Flowing/dripping candle wax, Bisphosphonates, Zoledronic acid


Melorheostosis is a sclerosing bone dysplasia of unknown aetiology. Diagnosis is mainly based on a combination of clinical and imaging studies. The classical dripping candle wax picture on plain radiograph is diagnostic. We report a case of localized melorheostosis of a 14 year old boy on daily analgesics for two years for pain relief. Radiographs showed endosteal bone formation like dripping candle wax. Biopsy and decompression of the hyperostosis was done. However biopsy did not relieve his symptoms. Based on literature survey he was given a single infusion of zoledronic acid. This gave dramatic relief in pain.

Author Biography

Suresh B, Subbaiah Institute of Medical Sciences, Purle, Shivamogga, Karnataka, India

Deptatment of Orthopaedics,

Subbaiah instititue of medical science

N.H 13, Holehonnur Road, 

Purle, Shivamogga- 577222


Gagliardi GG, Mahan KT. Melorheostosis: a literature review and case report with surgical considerations. J Foot Ankle Surg. 2010;49(1):80-5.

Jain VK, Arya RK, Bharadwaj M, Kumar S. Melorheostosis: clinicopathological features, diagnosis, and management. Orthopedics. 2009;32(7):512.

Greenspan A, Azouz EM. Bone dysplasia series. Melorheostosis: review and update. Can Assoc Radiol J. 1999;50(5):324-30.

Campbell CJ, Papademetriou T, Bonfiglio M. Melorheostosis. A report of the clinical, roentgenographic, and pathological findings in fourteen cases. J Bone Joint Surg Am. 1968;50(7):1281–304.

Taylor PM. Melorheostosis. J Foot Surg. 1976;15(2):55–8.

Freyschmidt J. Melorheostosis: a review of 23 cases. Eur Radiol. 2001;11(3):474–9.

Gong HS, Lee KH, Oh JH, Chung J-H, Baek GH, Chung MS. Successful elbow contracture release secondary to melorheostosis. A case report. J Bone Joint Surg Am. 2008;90(5):1106–11.

Ihde LL, Forrester DM, Gottsegen CJ, Masih S, Patel DB, Vachon LA, et al. Sclerosing bone dysplasias: review and differentiation from other causes of osteosclerosis. Radiogr Rev Publ Radiol Soc N Am Inc. 2011;31(7):1865–82.

Rozencwaig R, Wilson MR, McFarland GB. Melorheostosis. Am J Orthop Belle Mead NJ. 1997;26(2):83–9.

Siegel A, Williams H. Linear scleroderma and melorheostosis. Br J Radiol. 1992;65(771):266–8.

Judkiewicz AM, Murphey MD, Resnik CS, Newberg AH, Temple HT, Smith WS. Advanced imaging of melorheostosis with emphasis on MRI. Skeletal Radiol. 2001;30(8):447–53.

Hellemans J, Preobrazhenska O, Willaert A, Debeer P, Verdonk PCM, Costa T, et al. Loss-of-function mutations in LEMD3 result in osteopoikilosis, Buschke-Ollendorff syndrome and melorheostosis. Nat Genet. 2004;36(11):1213–8.

Lasserre C. A case of melorheostosis. Rev Rhum Mal Osteoartic. 1960;27:347–50.

Murray RO, McCredie J. Melorheostosis and the sclerotomes: a radiological correlation. Skeletal Radiol. 1979;4(2):57–71.

Fryns JP. Melorheostosis and somatic mosaicism. Am J Med Genet. 1995;58(2):199.

Spieth ME, Greenspan A, Forrester DM, Ansari AN, Kimura RL, Siegel ME. Radionuclide imaging in forme fruste of melorheostosis. Clin Nucl Med. 1994;19(6):512–5.

Kawabata H, Tsuyuguchi Y, Kawai H, Yasui N. Melorheostosis of the upper limb: a report of two cases. J Hand Surg. 1984;9(6):871–6.

Zeiller SC, Vaccaro AR, Wimberley DW, Albert TJ, Harrop JS, Hilibrand AS. Severe myelopathy resulting from melorheostosis of the cervicothoracic spine. A case report. J Bone Joint Surg Am. 2005;87(12):2759–62.

Zhang C, Dai W, Yang Y, Tang Q, Yao Z. Melorheostosis and a review of the literature in China. Intractable Rare Dis Res. 2013;2(2):51–4.

Saad F, Lipton A. Clinical benefits and considerations of bisphosphonate treatment in metastatic bone disease. Semin Oncol. 2007;34(4):17-23.

Theriault RL. Zoledronic acid (Zometa) use in bone disease. Expert Rev Anticancer Ther. 2003;3(2):157–66.

Wood J, Bonjean K, Ruetz S, Bellahcène A, Devy L, Foidart JM, et al. Novel antiangiogenic effects of the bisphosphonate compound zoledronic acid. J Pharmacol Exp Ther. 2002;302(3):1055–61.

Donáth J, Poór G, Kiss C, Fornet B, Genant H. A typical form of active melorheostosis and its treatment with bisphosphonate. Skeletal Radiol. 2002;31(12):709–13.

Khosla S, Burr D, Cauley J, Dempster DW, Ebeling PR, Felsenberg D, et al. Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2007;22(10):1479–91.






Case Reports