Unravelling the challenges in diagnosing Caffey disease.

Caffey disease, also known as Infantile Cortical Hyperostosis, is a rare yet significant self-limiting disorder that primarily affects infants. The condition is characterised by acute inflammation of the periosteum, cortical hyperostosis, and soft tissue swelling, often accompanied by systemic manifestations such as fever and irritability. The case describes a male infant with progressive left thigh swelling appearing 10 days post-immunisation, with no systemic symptoms. Examination revealed a bony-hard swelling with elevated inflammatory markers and alkaline phosphatase. Radiographs showed cortical thickening, and biopsy confirmed Caffey disease (Infantile Cortical Hyperostosis). Differential diagnoses like osteomyelitis and malignancy were ruled out. Conservative management with symptomatic relief led to complete resolution within 3 months, highlighting the importance of early diagnosis to avoid unnecessary interventions.