# Case Report: The role of bone scans in detecting Ribbing disease

## TL;DR

This case report shows how bone scans helped diagnose a rare bone condition called Ribbing disease in a young man with long-term leg pain.

## Contribution

Demonstrates the diagnostic value of bone scintigraphy in identifying Ribbing disease when standard imaging is inconclusive.

## Key findings

- Bone scintigraphy revealed multiple bone lesions consistent with Ribbing disease.
- Initial imaging misdiagnosed the condition as tibial bone marrow osteosclerosis.
- The case highlights the importance of advanced imaging for rare bone disorders.

## Abstract

In this case, we report the usefulness of bone scintigraphy in evaluating osteoarticular pain when the diagnosis is unclear after standard morphological imaging. A 24-year-old male patient exhibited mild left tibial pain that had been intensifying over a period of 2 years. The initial radiological evaluation suggested a diagnosis of pediatric tibial bone marrow osteosclerosis associated with periostitis, based on standard radiographs and MRI. However, a complementary bone scan was required for confirmation and showed moderate hyperemia and severe hyperfixation of the tibial lesion along with similar lesions on the left femur, both humeri, and the right ulna. These new findings led to a diagnosis of Ribbing disease, a rare sclerosing bone dysplasia.