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Caffey's disease or infantile cortical hyperostosis is a rare cause of irritability, bone pain, soft tissue swelling and fever in the infant.To review the presentation and diagnosis of an 8-week old infant with focal tenderness of the tibia.The symptoms, signs, laboratory work-up and radiology are reviewed.The child presented with focal bony tenderness and pyrexia. Laboratory work-up was inconclusive. The diagnosis of Caffey's disease was made following a skeletal survey to outrule non-accidental injury, which showed similar changes of cortical thickening in the mandible as well as the affected tibia.With our increasing immigrant population, an increasing number of differential diagnoses must be considered when evaluating patients presenting to our emergency rooms. Caffey's disease is an unusual cause of bone pain in the infant. Symptoms and signs are subtle and the diagnosis is generally made with plain X-rays.

Our review has shown that there has been a changing trend in THA component usage over the last 10 years. Our assumption is that this is secondary to a better understanding of optimal component fixation and soft tissue balancing. These observations are made with the knowledge that not all THAs are performed using Charnley components. The institution of a national arthroplasty register would be useful for identifying future trends.