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Paediatrics
Monostotic femoral Caffey disease masquerading as Ewing sarcoma
  1. Madhuri Kumari1,
  2. Surya Nandan Prasad2,
  3. Anamika Meena2 and
  4. Kundhan Pavan Kumar Tekkali2
  1. 1Department of Radiodiagnosis, All India Institute of Medical Sciences - Patna, Patna, Bihar, India
  2. 2Department of Radiodiagnosis, All India Institute of Medical Sciences – Patna, Patna, Bihar, India
  1. Correspondence to Dr Surya Nandan Prasad; drsurya1{at}gmail.com

Abstract

We describe a rare case of monostotic infantile cortical hyperostosis (Caffey disease) involving the left femur of an infant, who presented with recent onset left thigh swelling, following vaccination. Radiological workup showed a lamellated periosteal reaction involving the left femoral diaphysis on radiographs masquerading as a bone tumour. The child underwent MRI of the left thigh, which showed extensive muscle oedema without any abnormal soft-tissue proliferation, marrow signal alteration, cortical breach or collection. The follow-up radiograph showed exuberant new bone formation in the second week. The patient was given symptomatic treatment and the parents were counselled. The child recovered well with gradual resolution of symptoms and bony remodelling on a 6-month follow-up radiograph. Here, we describe the serial changes on the radiographs in Caffey disease with monostotic involvement and the role of MRI in difficult cases to differentiate it from other common mimickers, such as infections and neoplasia.

  • orthopaedics
  • paediatrics
  • radiology
  • rehabilitation medicine
  • connective tissue disease

https://doi.org/10.1136/bcr-2024-261790

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    Footnotes

    • X @Anam@1986

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: MK, SNP, AM, KPKT. The following authors gave final approval of the manuscript: MK, SNP, AM, KPKT.

    • 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.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

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