Severe myositis ossificans in a paraplegic trauma patient: Influence in pressure sore management

Myositis ossificans (MO) is a benign, progressive, ossifying lesion that displays a characteristic zonal histological appearance. MO traumatica is a localized form of heterotopic bone formation, associated with repetitive micro- and/or macrotrauma in the majority of cases. The importance of imaging to differentiate MO from sarcomatous change and to determine maturity of the lesion is identified because suboptimal operative intervention on immature MO inevitably results in recurrence. A severe case of MO in a 24-year-old paraplegic man with chronic bilateral greater trochanteric pressure sores is presented, and the importance of the MO in the etiology and treatment of this case is discussed. An extensive review of the literature is included and integrated.     

Usefulness of ultrasonography for early recurrent myositis ossificans

 Myositis ossificans is a benign heterotopic ossifying condition of soft tissues. The lesion may cause persistent functional impairment of adjacent joints. Surgical intervention is often needed to regain normal function, even though a high recurrence rate is reported. In the present case, we found that recurrent myositis ossificans could not be demonstrated by radiography during the early stage. However, ultrasonography proved to be an excellent tool for detecting early recurrence of myositis ossificans and for distinguishing the condition from extraosseous sarcomas. Received: July 16, 2002 / Accepted: November 18, 2002 Offprint requests to: A. Okayama     

MR imaging findings of an unusual case of myositis ossificans presenting as a progressive mass with features of fluid–fluid level

We present a case of myositis ossificans involving the upper arm in which features of fluid–fluid level became apparent on magnetic resonance imaging (MRI). Serial MR images obtained over a 6-month period exhibited progressive appearances in the absence of dense mineralization in the early and mid phases, which simulate neoplastic conditions. Twenty-four weeks following the biopsy, MR images revealed that the mass had decreased in size with the disappearance of most of the features of fluid–fluid level. To the best of our knowledge, no example of myositis ossificans accompanied by features of fluid–fluid level, which was closely monitored by MRI, exists in the literature. These features of image examination should be evaluated cautiously to avoid unnecessary surgical intervention, especially in instances where lesions exhibit expansive appearance. This case provided beneficial information regarding the sequence of changes in terms of MR appearance of myositis ossificans.     

股骨干骨折交锁髓内针内固定术后局部出现骨化性肌炎5例

股骨干骨折交锁髓内针固定术后局部出现骨化性肌炎(Myositis ossificans)鲜有报道,我科自2003年1月-2005年9月共发生5例,报告如下。1临床资料切开复位交锁髓内针内固定治疗股骨干骨折患者61例,术后均放置引流管(24～72h拔管)。术后发生局部骨化性肌炎的5例,均为男性,年龄22～46     

Myositis ossificans in the soft tissues of the hand

Summary Myositis ossiticans is a benign sort tissue tumor of unknown etiology characterized by the rapid development of swelling and pain. The occurrence of this lesion in the hand is uncommon. Initially, the roentgenograms are normal, but progressively a bony mass can be visualized in the soft tissues. The lesion is often mistaken for infection or malignancy. The definitive diagnosis is confirmed by biopsy which shows a typical zone phenomenon with three well differentiated areas of pathologic findings. A case is presented to illustrate the classic clinical evolution, radiologic findings and treatment of myositis ossificans affecting the soft tissues of the hand. The surgical treatment obtained an almost complete remission of symptoms and pathologic signs.     

Calcifying haematoma mimicking a soft tissue sarcoma and myositis ossificans

We describe a case of calcifying haematoma in a 78-year-old war veteran with a mass in his right lower leg. The likely differential diagnosis of myositis ossificans and soft tissue sarcoma was worked up. We discuss some of the difficulties of diagnosis despite having computed tomography and magnetic resonance imaging examinations and the unexpected final diagnosis of calcifying haematoma that was made on incisional biopsy.     

Myositis ossificans: A rare location in the foot. Report of a case and review of literature

BackgroundMyositis ossificans is a benign, tumor-like lesion characterized by heterotopic ossification of soft tissue that usually affects the elbow and thigh. At different stages of maturity, it show similar histologic appearances with sarcomatous lesions or maturing bone. Misdiagnosis can result in unnecessary radical treatment.Case reportA 50-year-old woman with dorsal forefoot soft tissue mass was diagnosed as myositis ossificans after surgical excision and confirmed by a histopathological examination.DiscussionTo our knowledge, myositis ossificans occurrence in the foot is rare and only a few cases have been reported in the literature.SummaryIncreasing awareness on the unusual sites for myositis ossificans occurrence is necessary for differentiating this lesion from a malignant soft- tissue tumors and avoiding diagnostic pitfalls and unnecessary investigations, which can have major consequences and complications for patients.     

Myositis ossificans in the right inferior thoracic wall as an unusual cause of lower thoracic-upper abdominal pain: Report of a case

We report a case of thoracic wall myositis ossificans (MO) located anterior to the ninth rib, causing right lower thoracic-upper abdominal pain. The diagnosis was based on the findings of ultrasonography (US) and computed tomography (CT). Numerous disorders can be included in the differential diagnosis of right lower thoracic-upper abdominal pain, so we must first establish if the pain is somatic or visceral in origin. Somatic pain in this region can be caused by traumatic muscle pain, overuse myalgia, costochondritis, or thoracic wall malignancies. Although rare, MO should also be considered in the differential diagnosis of pain and thoracic wall masses in this region. As the calcifications may not be seen on a plain chest X-ray in the early course of this condition, superficial tissue US or CT should be performed to establish the diagnosis.     

Anesthesia in a child with fibrodysplasia ossificans progressiva

We describe the anesthesia management of a 12-year-old girl, diagnosed with fibrodysplasia ossificans progressiva (FOP), who presented with a submandibular abscess. FOP is a rare, inherited disorder with heterotopic bone formation and progressive musculoskeletal disability. This disability ultimately confines patients to a wheelchair. Minor trauma following dental treatment may lead to ankylosis of the jaw. Subsequent to this disability, which resulted in poor dental hygiene, our patient developed a dental abscess. This spread along the mandibular margin and under the tongue. She presented with an impending airway compromise in an already difficult situation. The options for airway management in a child with limited mouth opening are discussed.     

True trilineage haematopoiesis in excised heterotopic ossification from a laparotomy scar: report of a case and literature review

We report a case of true trilineage haematopoiesis in an excised area of heterotopic ossification from an upper mid-line laparotomy scar. Heterotopic ossification is a rare complication of abdominal surgery and usually occurs when upper mid-line incisions are utilised. Whereas cases of heterotopic ossification in abdominal incisions are not exceedingly rare, true trilineage haematopoiesis in such an area of heterotopic ossification, to our knowledge, has only been previously reported once in the English literature.     

肘关节巨大滑膜软骨瘤1例

患者，男，33岁，右肘前一肿物，伴关节疼痛、活动受限2年，于2007年2月15日来就诊，以：①右肘滑膜软骨瘤；②右肘骨性关节炎收住。患者既往有右肘骨性关节炎病史，无外伤史。体检：右肘前内侧有一直径约2．5cm大小肿块，质硬，活动度差，压痛阳性，肘关节伸直120。     

Distal radioulnar joint dislocation in association with elbow injuries

Traumatic distal radioulnar joint (DRUJ) dislocation with or without an associated fracture is a rare injury. When coupled with a radial head fracture this is commonly known as the Essex-Lopresti injury. We report two cases of elbow dislocation with ipsilateral radial neck fractures and associated true DRUJ dislocations. This has not been previously described in the literature. In elbow injuries with wrist involvement, symptoms in the latter may be subtle. Due to inadequate examination of the affected joint, poor initial radiographic views, and general rarity of this injury, distal radioulnar joint dislocations are frequently missed. We hope our experience illustrates the need to examine thoroughly the joint above and below the injured site, and to be aware of the potential for DRUJ instability in all patients with elbow injuries.     

Transverse divergent dislocation of the elbow in adult: a 9-year follow-up

Transverse divergent dislocation of the elbow, in which the radius and ulna dislocate in diverging directions, is an extremely rare injury (19 cases have been reported in the literature). Usually, this type of elbow dislocation occurs in children, and an adult case is extremely rare. In this report, we present a case of a transverse divergent dislocation of elbow in a 20-year-old woman, treated with conservative method and long-arm cast immobilization. At 9 years, she had no pain in the elbow, returned to full activities and had normal function. The X-ray of the elbow was normal, except for a small nonunited bony fragment adjacent to the coronoid process of the ulna.     

Myositis ossificans traumatica of the deltoid ligament in a 34 year old recreational ice hockey player with a 15 year post-trauma follow-up: a case report and review of the literature

Myositis ossificans traumatica is a relatively common injury associated with sports especially those involving contact. It continues to frustrate both athlete and health practitioner alike due to its continued lack of treatment options and a lengthy natural history. This case study chronicles the observation of a 34 year old recreational ice hockey player who presented 7 years post-trauma, was diagnosed with myositis ossificans traumatica and was followed up on 8 years later (15 years post-trauma). This case report is suspected to be the first published case study of its kind. The literature review outlines the various types of myositis ossificans, its incidence, pathogenesis, differential diagnoses including osteosarcoma, and the various methods/modalities reported in its treatment.