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Case No. 07 - Answer


Caffey’s Disease (Infantile cortical hyperostosis)

Next: Radiograph of mandible often clinches the diagnosis

  • Periosteal thickening more evident on radiograph ( arrow)

Differential diagnoses

  • Osteomyelitis

  • Ewing’s sarcoma


Clues to diagnosis

  • Age ( usually seen infants younger than 6 months)

  • Often accompanied by fever, pain and irritability ( triad)

  • T2WI hyperintensity centred around the cortex

  • Response to NSAIDs is one diagnostic pointer

  • Marrow signal intensity of mandible remains normal ( against Ewing’s sarcoma)

  • Mandibular osteomyelitis at this age group is uncommon; unless complicating underlying diseases such as osteopetrosis


Caffey disease:

  • massive subperiosteal new bone formation usually involving the diaphyses of the long bones,  ribs, mandible, scapulae, and clavicles

  • Serum inflammatory markers are often elevated ( ESR, CRP)

  • Usually self-limiting disorder


Genetic testing

  • COL1A1 gene in chromosome17q21​.33 coding for collagen alpha 1 chain

Correct Answer Submitted by:


  1. Neha Dohare

  2. Ankit Sangwan

  3. Anuradha Dawani

  4. Mohit Gambhir

  5. Vikas Yadav

  6. R Praveen Kesav

  7. Narasimman Murugan

  8. Richa Yadav

  9. Madhuri Kumari