Diagnosis

The clinical features suggest a diagnosis of Infantile Cortical Hyperostosis, which is confirmed by X-rays. X rays usually show gross thickening of the cortical end of the involved bone or bones, which may not be apparent during the early phase because it begins to appear after the swellings, have manifested themselves. However, bony changes start occurring within a short time and are characteristic of the disease. Elevated ESR Anemia, Increased levels of the enzyme alkaline phosphatase are some of the laboratory findings associated with this condition.

The condition has been occasionally diagnosed in the womb before the birth of a newborn. 

Most of the bones of the body can be involved however it seldom involves finger bones (phalanges), spine (vertebral bodies) and bones of the hand (cuboidal bones). 

The condition should be differentiated from 'battered baby syndrome' (due to child abuse) as bony trauma is the most frequent x-ray finding in child abuse. In child abuse the limb bones are commonly affected. Most of these children are below the age of one year.


Treatment

The condition is self-limiting and regresses on its own within a period of few weeks to months and often goes unnoticed if present in a particularly benign form. Periods of remissions and exacerbations can occur. Steroids may be of some benefit in the symptomatic management of the disease. Sometimes deformities in the affected bone persist into adulthood and if they are present on the face, then corrective surgery is required. This is again for cosmetic purposes rather than for palliative purpose.