Glenoid labrum ossification and mechanical restriction of joint motion: extraosseous manifestations of melorheostosis.
We report a case of a 47-year-old man who presented with progressive loss of motion and pain in the right shoulder. Radiographs of the shoulder demonstrated dense ossification in the glenoid and humeral head with extension into the periarticular soft tissues. CT and MRI scans confirmed the radiographic findings and also revealed ossification of the glenoid labrum. A radiographic diagnosis of melorheostosis, an uncommon benign sclerosing bone dysplasia, was made. Because of the patient's severe symptomatology, he underwent total shoulder arthroplasty. Histological analysis of the resected masses was consistent with melorheostosis with a few areas covered by a cartilage cap. This case illustrates several uncommon but important features of melorheostosis, including mechanical obstruction of joint motion requiring joint replacement, ossification of the glenoid labrum, and cartilage-covering portions of the intra-articular masses, not to be confused with cartilage-producing tumors.
Subhas
N
N
Department of Diagnostic Radiology, Cleveland Clinic, Cleveland, OH, USA. subhasn@ccf.org
Sundaram
M
M
Bauer
T W
TW
Seitz
W H
WH
Recht
M P
MP
D001178:Arthroplasty / Q000379:methods; D003937:Diagnosis, Differential; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008557:Melorheostosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D016059:Range of Motion, Articular; D035583:Rare Diseases; D012720:Severity of Illness Index; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D020069:Shoulder Pain / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed