Diagnosis Of Myositis Ossificans Research Articles

Unusual myositis ossificans

We report the case of a 9-year-old girl who presented to the emergency unit with general asthenia, myalgia, and difficulty to walk and stand evolving from 1 month. The diagnosis of myositis ossificans was ultimately made on clinical and conventional radiography finding. This case presents a rare form of myositis ossificans and highlights the contribution of the conventional radiography in the diagnosis workup of myositis ossificans.

A nontraumatic myositis ossificans case of the forearm: Case report and literature review.

Myositis ossificans (MO) is a rare, benign ossifying lesion characterized by focal formation of heterotopic bone and cartilage in extraskeletal soft-tissue that most commonly occurs in young adults. In most cases, no causative factor can be identified. The diagnosis of MO is usually based on the patient's history of trauma, clinical signs, on imaging appearance and histological examination. We present a non-traumatic MO case of the forearm in a 40-year-old man with weakness in left finger motion, a decrease in prehension for more than three weeks, without any weight loss, malaise, anorexia or fever. The clinical symptoms and radiological findings can be easily confused with malignant lesions. Treatment is usually conservative but, due to the limited strength and range of motion of the left hand, the tumor was extirpated and the diagnosis of MO was made by biopsy. The patient had no neurological deficits after surgical treatment and was discharged on the fifth day after the surgery in good condition with the recommendation to begin a rehabilitation program.

Myositis ossificans traumatica (circumscripta) and return to sport: A retrospective series of 19 cases

ObjectiveMyositis ossificans is a worrisome complication of muscle lesions in sports medicine. Our goal is to specify clinical, paraclinical and therapeutic elements to guide a myositis ossificans traumatica patient back into sport. MethodAll patients having consulted between January 2006 and December 2012 presenting myositis ossificans with a recent muscle injury from playing sports were included. We excluded patients with myositis ossificans without an identified trauma, or from an old injury (>6 months). Ultrasound images were captured on a Philips® Sparq ultrasound machine with a linear probe (4–12MHz). The diagnosis of myositis ossificans was performed on 2 ultrasound criteria in context of recent muscle trauma: presence of ossification or calcification within a muscle on axial and longitudinal sections using B-mode and hyperactivity in power Doppler mode around the ossification/calcification. Clinical signs and treatment were collected systematically at inclusion, 6 months and 1 year. ResultsAmong the 22 myositis ossificans cases diagnosed between January 2006 and December 2012, 19 were of traumatic origin, on a recent muscle lesion and were included in the study. Our patients resumed light physical activities 3 months after diagnosis for 89.5% of them (100% at 10 months) and returned to their earlier level 6 months after myositis ossificans diagnosis for also 89.5% of them (all patients having resumed sport at their earlier levels 12 months after diagnosis). ConclusionTherapeutic abstention and persistence of ossification do not seem to be detrimental factors for resuming a sport at the earlier level with ultrasound monitoring.

Nontraumatic Myositis Ossificans of Hip: A Case Presentation.

In most of the cases trauma is the leading etiology and the nontraumatic myositis ossificans (MO) is a very rare condition. We present an MO case without any trauma occurring. A 36-year-old female patient with a history of pain and restriction of range of motion of the left hip was admitted. Hip motions were restricted with 10–60° of flexion, 10° of internal rotation, 20° of external rotation, 10° of abduction, and 10° of adduction. There was no history of trauma and familial involvement. The biopsy of the lesion revealed mature bone tissue confirming our diagnosis of MO. The mass was removed surgically and postoperatively the patient was treated with a single dose radiotherapy with 800 gyc. MO is a benign and well differentiated bone formation or in other words heterotopic ossification of the muscle tissue. It has a prevalence of less than 1/1 million. Trauma is the most frequent etiological factor seen in almost 60–75% of the cases. Nontraumatic MO is very rare in the literature. Our patient had no history of trauma or familial involvement. Combination of the surgical excision with radiotherapy in the treatment of the MO of the hip may give satisfactory results.

Self-resolving focal non-ossifying myositis: a poorly known clinical and imaging entity diagnosed with MRI.

BackgroundFocal myositis is a rare benign inflammatory pseudotumor, presenting as a painful nodular mass within a muscle, and characterized by spontaneous resolution within weeks.PurposeTo assess the clinical and imaging findings of focal nodular myositis simulating a neoplasm at clinical examination, with no history of trauma.Material and MethodsThis study describes the locations and appearance at ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) of this condition in a series of five patients.ResultsMRI and US displayed a solid intramuscular “tumor” and suggested a continuum between the proximal and distal muscle fibers that appeared thickened within the nodular lesion, a sign that has been reported in myositis ossificans. MRI showed edema in adjacent muscles and soft tissues, as well as intense enhancement of the mass. Intense vascular flows were seen at Doppler analysis. CT did not reveal the appearance of peripheral ossifications, ruling out the diagnosis of myositis ossificans. In some patients, the diagnosis of sarcoma had been suggested as possible by the radiologist. Imaging follow-up with MRI showed complete resolution of the masses over several weeks, thus avoiding a biopsy; no recurrence was observed at long-term follow-up (more than 24 months).ConclusionThis paper highlights MRI and US findings in focal non-ossifying myositis, and emphasizes the role of MRI in suggesting this diagnosis, leading to the careful follow-up of the lesion until its resolution, and ruling out more aggressive lesions.

Myositis ossificans in the paraspinal muscles of the neck after acupuncture: a case report

Background contextAlthough traumatic myositis ossificans (MO) has been reported occasionally, MO of paraspinal muscles has been rarely seen in the cervical spine after minor injury. This is difficult to distinguish from benign and malignant soft lesions in cases of a lack of definite trauma history. PurposeWe report a case of MO in the cervical paraspinal muscle after acupuncture and describe methods for diagnosis and proper treatment, including classification, etiology, and radiologic and histologic features. Study designCase report. MethodsA 26-year-old woman complained of posterior neck pain that had began 2 months earlier and neck swelling after acupuncture. No abnormal finding existed on the X-ray except soft tissue swelling. Magnetic resonance imaging was evaluated because of constant neck pain. To obtain more accurate assessment, computed tomography-guided biopsy was performed and a diagnosis of MO was made. ResultsThe patient was conservatively treated through rest and analgesics. Posterior neck pain and swelling improved for a several months. The hyperdensity was comparable with the bony density, and the size of the calcified lesion on X-ray diminished until the last follow-up. ConclusionsMyositis ossificans that can occur after acupuncture should be recognized as a possible cause of persistent neck pain and swelling despite no definite trauma after thorough evaluation of the neoplasm and infection.

측두근과 외측 익돌근에서 발생된 국한성 화골성 근염 : 개구제한을 주소로 내원한 환자의 증례보고

국한성 화골성 근염은 근육내에 섬유조직과 이소성 골이 형성되는 질환으로 외상성 화골성 근염으로도 알려져 있으며 외상, 외과적 술식, 지속적인 자극에 의하여 근육이 골화되는 질환이다. 주로 팔, 다리 근육에서 발생되며, 저작근에서 발생되는 예는 드물다. 저작근에 발생된 경우 주된 임상증상은 개구제한이며 환자는 이환부위의 동통이나 불편함을 호소하기도 한다. 본 연구는 30대 남성이 개구제한을 주소로 내원하여 임상검사와 방사선검사 후 저작근중에서 좌측 측두근과 외측 익돌근에서 발생된 국한성 화골성 근염으로 진단 내려진 증례를 보고하고자 한다. Localized myositis ossificans is a disease with the main feature of formation of heterotropic bone and fibrous tissue involving muscle. It also called traumatic myositis ossificans. Myositis ossificans is likely to occur in the femoral region or brachium but, rarely in the head and neck including the masticatory muscles. It arises from traumatic episodes caused by prolonged mouth opening, surgical procedure, local anesthesia injection. The main clinical feature is the mouth open limitation. The diagnosis of myositis ossificans is usually based on the patient's history, clinical symptoms and on imaging finding. We present the case of patient with localized myositis ossificans of the temporal and lateral pterygoid muscles.

A case of parosteal osteosarcoma with a rare complication of myositis ossificans

We report the case of a parosteal osteosarcoma of the distal ulna, treated with wide resection without reconstruction. The patient developed lung metastasis and a mass in the interosseus membrane of the forearm proximally to the osteotomy. The lung mass was found to be a metastasis from parosteal osteosarcoma and the biopsy of the forearm mass revealed a myositis ossificans. The suspicion of a recurrence of parosteal osteosarcoma, already metastatic, led to a second wide resection with no reconstruction. A slice of the radial cortex was taken during this second procedure. From a histological point of view, good margins were achieved and diagnosis of myositis ossificans was confirmed. Two months later, a radius fracture occurred and a synthesis, with plate and screws, as added with poly(methyl methacrylate) (PMMA) to reconstruct the bone loss, was performed. Indication of the reconstructive technique and the complication after distal ulna resection in oncologic surgery are discussed in this paper.

Non Traumatic Myositis Ossificans Mimicking a Malignant Neoplasm: A Case Report

Myositis ossificans is a benign self limiting condition that usually related to trauma. Despite a clinically and histologically distinct entity, myositis ossificans still causes considerable difficulties in diagnosis. A 33-year-old Moroccan woman presented with a 2-month history of left inguinal inflammatory pain with limping gait, MRI examination suggested a malignant neoplasm such as soft tissue osteosarcoma. A diagnosis of myositis ossificans was made by incisional biopsy. Conservative management with clinical and radiological follow up of 19 months confirm the diagnosis. The symptoms resolved within seven months. Myositis ossificans should be considered by clinicians as a possible diagnosis for a soft tissue lesion.

A Case of Myositis Ossificans in the Upper Cervical Spine of a Young Child

Case report. We present a case of myositis ossificans (MO) of the upper cervical spine in a young child. The literature is reviewed with the classification, etiology, and treatment of MO discussed. Calcification of joint capsule, muscle, cartilage, and ligaments is a well-known phenomenon and is known as myositis ossificans. It is very rarely seen in the head and neck, with no reports of MO of the soft tissues surrounding the first 2 cervical vertebrae. An 8-year-old boy presented with severe neck pain after a fall. He had had a similar neck injury 4 years before, but made a full recovery. Radiographs showed a large ossified lesion between the posterior elements of C1 and C2. After further imaging, a diagnosis of MO was made. The child was treated with simple analgesia and observation. With no evidence of neurologic compromise and minimal symptoms, there was no indication for surgical intervention. Although rare, MO should be suspected as one of the possible causes of persistent pain following cervical spine injury in children. We would advise a low threshold for cervical spine imaging in the child presenting with persistent neck pain and stiffness, even years after injury.

Non-traumatic myositis ossificans mimicking a malignant neoplasm in an 83-year-old woman: a case report

IntroductionMyositis ossificans is a benign, self-limiting condition that usually affects young, athletically active men. To the best of our knowledge, this case report describes the oldest recorded patient with myositis ossificans.Case presentationOur patient was an 83-year-old Japanese woman who presented with a one week history of a palpable mass in the left thigh. She had a history of surgery for transverse colon cancer and lung cancer at the ages of 73 and 80, respectively. Clinical and radiological examinations suggested a malignant neoplasm such as metastatic carcinoma or extraskeletal osteosarcoma. A diagnosis of myositis ossificans was made by core needle biopsy. Our patient was asymptomatic and had no recurrence at one year follow-up.ConclusionClinicians should consider myositis ossificans as a possible diagnosis for a soft tissue mass in the limb of an older patient, thereby avoiding unnecessarily aggressive therapy.

Bone scintigraphy in electrocution wounds and comparison with FDG-PET images

One can follow the order of events that happened to this unfortunate man: The cable hits the shoulder and slides onto his back and left hip, while his right hip makes contact with a metal bar, allowing the current to leave his body (arrows). Both hands bear the signs of his attempts to throw the cable away. Positron emission tomography/computerized tomography (PET–CT) was performed to evaluate bone involvement and to provide better anatomic repair. Thus, we could exclude osteomyelitis and confirm the diagnosis of myositis ossificans caused by electrical burns (d and e). Our patient survived and could leave the hospital after treatment consisting of several autograft operations. Eur J Nucl Med Mol Imaging (2008) 35:448 DOI 10.1007/s00259-007-0629-5

Fibro-osseous pseudotumor in the neck: Report of a case and literature review

Objectives: We present a case of fibro-osseous pseudotumor in an adolescent male with a 1-month history of a right posterior neck mass. We present the differential diagnosis, radiographic, clinical, surgical, and pathologic aspects, and a review of the medical literature for this rare and unusual fibro-osseous pseudotumor presenting in this location. Methods: Fibro-osseous pseudotumor is reported to occur in the digits, toes, and neural axis, falling under a diagnosis of myositis ossificans. This patient presented with a large fibro-osseous pseudotumor in the neck that has not been identified in the medical literature. Results: Fibro-osseous pseudotumor is a benign soft tissue lesion that usually affects the digits but has also been known to occur in the neural axis. Fine needle aspiration was nondiagnostic and magnetic resonance imaging showed a large mass posterior to the carotid sheath and deep to the trapezius and splenius capitis muscles. Excisional biopsy demonstrated fibro-osseous pseudotumor. Conclusion: Fibro-osseous pseudotumor is benign, soft tissue growth that has not been previously reported in the neck. These tumors present as a poorly defined soft tissue mass with calcification or focal periosteal thickening but do not involve adjacent bone. This poster demonstrates a well-defined mass in a new location for fibro-osseous pseudotumor. It includes the differential diagnosis, radiographic, clinical, surgical, and pathologic aspects of this disease and a review the medical literature.

Myositis ossificans of psoas muscle: magnetic resonance imaging findings

Myositis ossificans is a benign, localized, self-limiting ossifying soft tissue mass with unknown pathogenesis. It may be confused with a malignant tumor of bone or soft tissues, especially in the early stages of the disease. In this report, we present a case of myositis ossificans affecting unilateral psoas muscle, which to our knowledge is a very uncommon location. There was no history of trauma. We describe the imaging findings and clues to early diagnosis of myositis ossificans.

Melanotic schwannoma mimicking myositis ossificans.

Pelvic radiographs of a 20-year-old woman showed a bony mass lesion lateral to the left iliac bone. CT and Tc-99m MDP whole-body scanning were also performed for further assessment. All studies strongly suggested a diagnosis of myositis ossificans; however, a pathologic diagnosis of melanotic schwannoma was made after the mass was excised. Cases of melanotic schwannoma have been reported in different anatomic locations, some of which were reported to be a component of the Carney complex. Further diagnostic work-up in this patient revealed no other signs of this complex.

LARYNGEAL MYOSITIS OSSIFICANS: A CASE REPORT.

ACCORDING to Ackerman and Spjut¹myositis ossificans is a term loosely applied to a group of soft tissue conditions. The term in their opinion is misleading, however, since myositis implies inflammation, which is lacking, of muscle and may or may not be present. Also, early in its evolution there is no bone present, and sometimes there is no anatomic relation of the lesion to bony structures. For these reasons the term heterotopic nonneoplastic bone formation is probably preferable to myositis ossificans for these lesions. Lewis⁴found in his study of 127 cases of myositis ossificans that the condition is almost always noted in the large skeletal muscle groups of the extremities, but that it may be seen in smaller skeletal muscles such as in the thenar eminence and in the temporal muscle. Ackerman and Spjut¹state that the diagnosis of myositis ossificans is difficult to make from