Melorheostosis is a noncancerous bone disease characterized by abnormal bone and soft tissue growth. Despite being identified almost a century ago, there are still many unknown aspects surrounding this condition. It can often be an incidental discovery, with patients experiencing associated pain and deformities. Diagnosis typically relies on X-rays, although not all cases exhibit the classic candle wax appearance. A new imaging sign known as the \"dumpling on a plate sign\" has been proposed for flat bones for both MRI and CT scans. A biopsy may be necessary in cases of uncertainty, as there is not a definitive histological feature. It is not uncommon for melorheostosis to be linked with other conditions, and a collaborative approach involving a multidisciplinary team should be considered. This condition should be considered in the differential diagnosis of sclerotic bone conditions. Management is generally aimed at symptom relief, either through conservative measures or surgical intervention.

It is important to consider the rare case of a melorheostosis in patients presenting with soft tissue swelling, joint contractures, and \"dripping candle wax\"-like hyperostoses visible on hand radiographs. Clinical sequelae such as carpal tunnel syndrome or trigger finger have to be ruled out. Symptomatic therapy is usually sufficient.