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Ribbing disease of tibia: a rare entity
  1. Sibasish Panigrahi1,
  2. Bishnu Prasad Patro2,
  3. Ayesha Mohapatra2 and
  4. Saroj Kumar Patra2
  1. 1Department of Orthopaedics, AIIMS Bhubaneswar, Bhubaneswar, Orissa, India
  2. 2All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
  1. Correspondence to Dr Sibasish Panigrahi; vickysp88{at}gmail.com

Abstract

Establishing the cause of unilateral leg pain is difficult in the settings of tibial diaphyseal sclerosis. This patient, a 36-year-old woman presented with unilateral pretibial leg pain for past 7 months without history of trauma, infections, systemic or metabolic disease. Besides local deep tenderness, other clinical findings and blood investigations were normal. Radiograph and CT scan showed both periosteal and endosteal cortical thickening with obliteration of medulla of the tibial midshaft. MRI scan detected marrow oedema and bone scan revealed increased tracer uptake at the affected site of tibia. She was treated by saucerisation and re-establishment of the medullary canal. Biopsy of the harvested tissue had trabecular bone without any sign of inflammation. Patient was pain free after 3 months of operation and was able to perform her activity of daily living without any difficulties. Ribbing disease is a disease of exclusion and need high degree of suspicion for its diagnosis.

  • orthopaedics
  • radiology
  • orthopaedic and trauma surgery

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Footnotes

  • Contributors BPP, SP and SKP managed the case. SP and AM prepared the initial manuscript. BPP provided intellectual content to the manuscript. All authors read the manuscript and approved for publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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