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Case of the Week 548



What is the most likely diagnosis?

  • 43 year-old in a previous swimming pool accident



Frontal Radiograph of Pelvis

  1. Osteosarcoma
  2. Paget's disease
  3. Healed Fracture
  4. Heterotopic ossification
  5. Hypervitaminosis D

Additional Images - None

 

Additional Images

 


None


Answer:

 

4. Heterotopic ossification

 

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Heterotopic ossification

General considerations

  • Defined as the abnormal formation of true bone within extra-skeletal soft tissues
  • More common in males, especially following spinal cord injury, it is rare in young children
  • Formerly called myositis ossificans
    • That term has fallen out of favor because the condition is not always inflammatory and ossification occurs in soft tissues other than muscle
  • Strong association exists between HO and spinal cord or traumatic brain injury
    • About 20-30% of patients with neurologic deficits will develop HO, possibly higher with spinal cord injuries
  • It is also seen in burn patients, following surgery, and following blunt trauma such as horse riders may develop in the adductor muscles of the leg
  • There is an increased risk for HO in patients with Diffuse Idiopathic Skeletal Hyperostosis (DISH) and Paget’s Disease

MORE . . .

 


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