A Rare Case of Ribbing Disease– Diagnosis and Management

INTRODUCTION: Ribbing diseases is rare and have only been occasionally reported. We here in report a case of Ribbing disease affecting bilateral tibia which was diagnosed based on computed tomography (CT), magnetic resonance imaging (MRI), and histopathological features and managed by intramedullary reaming . CASE REPORT: A 45 - year - old female presented with complaints of pain in the right leg for the past four 4 months duration and the patient had similar complaints of pain in the left leg 3 years back for which she had had taken treatment at an outside hospital where she underwent saucerization of the left tibia as a case of low- grade osteomyelitis . To evaluate the cause of pain X-ray, CT and, MRI were done which were suggestive of Ribbings disease and biopsy was performed which favoured the diagnosis of Ribbings disease. The patient was tried on a course of analgesics , with no symptomatic betterment , after going through the literature, the patient was taken up for the right tibia intramedullary reaming. Post operatively, the patient symptomatically improved and is pain free for the past 4 years. CONCLUSION : Ribbing disease is an uncommon cause of a common symptom. It is a rare diaphyseal sclerosing dysplasia. With lack of clinical signs of infection and biochemical evidence of metabolic bone disease and positive clinical, radiological and histological features in favour of ribbing disease helped us in arriving at the diagnosis. Intramedullary reaming of the affected bone has been useful in providing symptomatic betterment .