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myositis ossificans
Etiology:
- trauma, especially skeletal muscle trauma
- premature return to activity after an injury
- hereditary form
Pathology:
- inflammatory myopathy [5]
- extraskeletal calcification typically involving striated muscle & soft tissue
Genetics:
- autosomal dominant (fibrodysplasia ossificans progressiva)
Clinical manifestations:
- pain
- limitation of joint movement
- 80% of ossifications arise in the thigh or arm
- other sites of ossification include:
- intercostal spaces, erector spinae, pectoralis muscles, gluteus maximus, gluteus minimus, chest
- pain & mass diminish with time
Special laboratory:
- ultrasonography (US)
- calcification may be detected 2 weeks earlier on ultrasound than on radiography Radiography:
- hazy densities are sometimes noted ~ one month after injury
- denser opacities may appear two months after injury
- calcification fully matures in > 6 months after injury
Differential diagnosis:
- may be confused with sarcoma
Complications:
- nerve compression
Management:
- rest
- immobilization
- physical therapy
- NSAIDs
Specific
fibrodysplasia ossificans progressiva
General
muscular disease; myopathy
References
- Saunders Manual of Medical Practice, Rakel (ed), WB Saunders,
Philadelphia, 1996, pg 671-72
- Wikipedia: Myositis ossificans
http://en.wikipedia.org/wiki/Myositis_ossificans
- Martin DA and Senanayake S
Images in clinical medicine. Myositis Ossificans
N Engl J Med 2011; 364:758February 24, 2011
PMID: 21345105
http://www.nejm.org/doi/full/10.1056/NEJMicm1005605
- Yu Chuah T, Loh TP, Loi HY, Lee KH.
Myositis Ossificans.
West J Emerg Med. 2011 November; 12(4): 371.
PMID: 22224121
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3236150/
- Lacout A et al
Myositis ossificans imaging: keys to successful diagnosis.
Indian J Radiol Imaging. 2012. Jan-Mar; 22(1): 35-39
PMID: 22623814
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354355/