Ribbing disease of bilateral tibial diaphyses: A case report and literature review

Ribbing disease is a rare sclerosing bone dysplasia characterized by benign endosteal and periosteal bone growth confined to the diaphyses of long bones, typically affecting the lower extremities. We present a case of a 31-year-old female with bilateral tibial diaphyseal involvement, highlighting the diagnostic challenges, clinical presentation, and management of this rare condition. The patient presented with progressive pain in both tibiae, which was initially misdiagnosed as chronic sclerosing osteomyelitis. Radiographic imaging, including X-rays and MRI, revealed characteristic diaphyseal sclerosis with medullary canal obliteration. Histopathological examination confirmed the absence of malignancy or infection. The patient underwent surgical fenestration of the sclerotic bone, resulting in significant pain relief. This case underscores the importance of considering Ribbing disease in the differential diagnosis of unilateral or bilateral lower extremity pain with diaphyseal sclerosis, and highlights the role of surgical intervention in managing refractory pain.