Melorheostosis: an unusual cause of dactylitis

A 17-year-old boy presented with a six-month history of spontaneous pain and stiffness in his right index finger. On examination there was mild diffuse swelling   and   tenderness   of   the   right   index   finger,   particularly   over   the metacarpophalangeal  and  proximal  interphalangeal  joints.  A  plain  radiograph
provided the diagnosis of melorheostosis, clearly showing the flowing candle wax-like appearance over the second and third metacarpals and the phalanges of the index and middle fingers.