Multiple diaphyseal sclerosis (Ribbing disease): what about neridronate?
Sclerosing bone disorders are uncommon diseases and represent a diagnostic challenge. Osteocondensation is a bone alteration, involving both acquired and hereditary conditions. Multiple diaphyseal sclerosis (Ribbing disease) is an inherited condition. It is characterized by excessive proliferation of endosteal and periosteal osseous tissue at the diaphyses of long bones, especially of tibias and femurs. The conventional radiology depicts cortical thickening of diaphyses of long bones while bone scintigraphy shows characteristically an abnormal tracer concentration in the involved diaphyses. The magnetic resonance imaging (MRI) examination confirms the presence of sclerosis and reveals bone marrow edema in the diaphyses of the afflicted bones. Due to the lack of knowledge of the pathophysiology, the treatment is empirical with glucocorticoids or bisphosphonates. Concerning bisphosphonates, the literature reports are conflicting. We report the case of a patient that showed lack of response to intravenous neridronate within 1 year of treatment, both in terms of pain and persistence of bone marrow edema at MRI.
Rheumatology Department, Polytechnic University of the Marche, c/o Ospedale "Carlo Urbani", Via Aldo Moro, 25, 60035, Jesi (AN), Italy. dica.marco@yahoo.it.
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Di Carlo
Rheumatology Department, Polytechnic University of the Marche, c/o Ospedale "Carlo Urbani", Via Aldo Moro, 25, 60035, Jesi (AN), Italy.
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Silveri
Rheumatology Department, Polytechnic University of the Marche, c/o Ospedale "Carlo Urbani", Via Aldo Moro, 25, 60035, Jesi (AN), Italy.|Internal Medicine Department, "C. and G. Mazzoni" Hospital, Area Vasta 5, Ascoli Piceno, Italy.
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Tardella
Radiology Department, Polytechnic University of the Marche, Ancona, Italy.
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Carotti
Rheumatology Department, Polytechnic University of the Marche, c/o Ospedale "Carlo Urbani", Via Aldo Moro, 25, 60035, Jesi (AN), Italy.
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Salaffi
D003966:Camurati-Engelmann Syndrome / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D018483:Diaphyses / Q000000981:diagnostic imaging / Q000473:pathology; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010017:Osteoma, Osteoid / Q000000981:diagnostic imaging* / Q000188:drug therapy*
D004164:Diphosphonates; C053389:6-amino-1-hydroxyhexane-1,1-diphosphonate
Bisphosphonates; Magnetic resonance imaging; Neridronate; Ribbing disease