Une complication musculaire rarissime de l’hémophilie: la myosite ossifiante

Abstract

Circumscribed myositis ossificans is a benign condition characterized by heterotopic growth of bone in soft tissues. It usually occurs in adolescents or young adults. Very rare cases have been described among children. Its etiopathogenesis is not clear, however, it seems that a focal muscle necrosis or a hematoma may cause the lesion. The most common sites are the quadriceps and biceps brachii. We report the case of a 20-year-old patient with a personal history of hemophilia A, admitted in our Department of Physical Medicine and Functional Rehabilitation to receive treatment for both hip mobility limitation. This one was caused, one year before, by a fall of patient own height: the patient impacted on both hips with resulting pain and swelling to their level. Evolution was marked by progressive mobility limitation of both hips, resulting in functional impairment and reduction in walking space. Clinical examination objectified a painful limitation of both hip range of motion with no further accompanying sign. Standard radiographs and pelvic TC scan showed a muscle ossification around both hips, whose appearances was compatible with progressive myositis ossificans of femoris square muscle of both sides and of right inferior gemellus muscle. Surgery was proposed but rejected by the patient. He then received medical treatment and pain rehabilitation. Evolution was marked by a slight improvement in function.