A 35-year-old female was hospitalized after the discovery of a mass in her left wrist, accompanied by limited mobility persisting for over three months. Upon admission, a physical examination revealed a palpable mass on her left wrist measuring approximately 1.0 × 2.0 cm. The mass displayed a firm texture, indistinct boundaries, limited mobility, and no apparent adhesion to surrounding tissues. Assessment of the left wrist joint revealed volar flexion of 25°, dorsiflexion of 10°, ulnar deviation of 10°, and radial deviation of 5°. There were no signs of arm swelling, varicose veins, or local tenderness. The patient exhibited normal finger mobility, forearm muscle strength, skin temperature, and peripheral blood supply. Furthermore, there was no reported family history of hereditary diseases.
The digital radiography (DR) revealed strip-like high-density shadows present on the radial side within the medullary cavity of the middle and distal segments of the left radius. Additionally, patchy high-density shadows were observed on the lateral side of the navicular bone, with no evident bone abnormalities detected in the remaining left radius and ulna. (Fig. 1A, B)
The patient was diagnosed with melorheostosis affecting the left radius and navicular bone.
Treatment involved the resection of osteophytes in the left wrist joint. A longitudinal incision measuring seven centimeters was made along the anterolateral side of the left wrist, with a layer-by-layer dissection of the skin and subcutaneous tissue. Two protrusions near the styloid process on the anterolateral side of the distal radius were identified during the procedure. These condyles, approximately 2.0 cm and 1.5 cm in length respectively, were fully exposed down to the pedicle. Subsequently, the condyles were completely excised from the base, leaving a 0.5 cm margin beyond the edge. Intraoperative pathology confirmed the presence of melorheostosis (Fig. 2). The patient's postoperative recovery was deemed satisfactory (Fig. 1E, F).
Subsequent follow-up examinations at 3, 6, and 12 months post-surgery revealed no apparent signs of proliferation or recurrence (Fig. 1C, D). The patient exhibited satisfactory wrist mobility during these evaluations (Fig. 3).