Myositis Ossificans Research Articles

Inverted horn myositis ossificans circumscripta in the pelvis and bilateral adductors: an unreported shape at an unusual site

ANZ Journal of SurgeryVolume 92, Issue 11 p. 3040-3041 IMAGES FOR SURGEONS Inverted horn myositis ossificans circumscripta in the pelvis and bilateral adductors: an unreported shape at an unusual site Satvik N. Pai MBBS, Satvik N. Pai MBBS orcid.org/0000-0002-3621-150X Department of Orthopaedic Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, India Contribution: Conceptualization, ​Investigation, Methodology, Visualization, Writing - original draft, Writing - review & editingSearch for more papers by this authorMohan M. Kumar MBBS, MS (Ortho), DNB, Mohan M. Kumar MBBS, MS (Ortho), DNB Department of Orthopaedic Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, India Contribution: ​Investigation, Methodology, Project administration, Supervision, Writing - review & editingSearch for more papers by this author Satvik N. Pai MBBS, Satvik N. Pai MBBS orcid.org/0000-0002-3621-150X Department of Orthopaedic Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, India Contribution: Conceptualization, ​Investigation, Methodology, Visualization, Writing - original draft, Writing - review & editingSearch for more papers by this authorMohan M. Kumar MBBS, MS (Ortho), DNB, Mohan M. Kumar MBBS, MS (Ortho), DNB Department of Orthopaedic Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, India Contribution: ​Investigation, Methodology, Project administration, Supervision, Writing - review & editingSearch for more papers by this author First published: 25 January 2022 https://doi.org/10.1111/ans.17502Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume92, Issue11November 2022Pages 3040-3041 RelatedInformation

A Case of Tibial Greenstick Fracture Complicated by Myositis Ossificans in a Child

Greenstick fracture; Complete fracture; Myositis ossificans

Fibrodysplasia Ossificans Progressive: A Case Report on Rare Musculoskeletal Disorder

Fibrodysplasia Ossificans Progressive (FOP) (also known as Myositis ossificans progressiva/Stone man disease/Munchmeyer’s disease) is one of the unfamiliar congenital disorders affecting the musculoskeletal system. It is characterised by extraosseous progressive heterotrophic osteogenesis in muscle, tendon, and ligament and associated deformities in toes. It starts around the age of 3-5 years and aggressively involves the musculoskeletal system; the affected child becomes immobile in the early twenties. The early phase of the disease is often misdiagnosed by medical experts due to its rarity and unfamiliarity. This was a case of FOP in a 5-year-old female child from western Uttar Pradesh. The presenting complaints were swelling in the lower back region, which was gradually increasing in size, and bilateral foot deformity. The diagnosis of FOP was based on elaborated history, clinical examination, and radiological investigation of the skeletal malformations. The child was provided with symptomatic treatment and her parents were counselled regarding the disease course.

Bone chip versus myositis ossificans after supracondylar fracture of humerus.

A 44-year-old male presented to the department of physiotherapy with the primary concern of inability to fully straighten his right elbow. As per the history given by the patient, he had sustained a fall on an outstretched hand 10 months ago. He had sustained a fracture around the elbow, which was managed conservatively with plaster cast for six weeks by a local practitioner. He had pain and swelling around the elbow after the injury, but it had subsided two months ago. On examination, terminal 30 degrees of the range of motion (ROM) of right elbow was limited. Although, forearm supination-pronation was full. The X-ray revealed bone chip at the anterior aspect of the distal humerus, along with supracondylar fracture of the humerus that was not completely healed. Bone chip can be differentiated from myositis ossificans, which is a common complication of fractures around the elbow, by its well-defined margins. As a part of physiotherapy intervention, gentle active ROM of right elbow and functional use of right hand for light activities of daily living was emphasized. The patient was advised to avoid use of heat, massage and jerky movements of elbow as these can lead to myositis ossification. He was assured that he had functional ROM of 30 degrees to 130 degrees elbow flexion, so lack of terminal extension should not bother him in his lifestyle.

Restoration of neglected fracture dislocation hip in elderly: a case report

<p class="abstract">Neglected traumatic fracture dislocation of the hip is a challenging problem due to soft tissue contractures, adhesions, fibro fatty tissue filling acetabulum, avascular necrosis, arthritis and myositis ossificans. These types of injury often get missed at initial evaluation in the presence of distracting injuries and in poly trauma patients. Femoral head fractures account for only 7-16% of all hip fracture dislocations, with combined femoral head and acetabular fractures in elderly being even lower. Literature favours primary hip replacement as compared to hip salvage in age above 60 years and in patients with neglected hip fracture dislocations of more than 3 months duration due to high chances of afore mentioned complications. Here, we report a case of 69 years old male with neglected hip fracture dislocation associated with posterior acetabular wall and femoral head fracture for the challenges in management with a total hip replacement.</p>

A Case Report of Capitellum Fracture Treated using Herbert Screw

Capitellar fractures are intra-articular elbow injury & it is an uncommon type of elbow injuries that can cause and affect severe functional limitation if not treated correctly. Various treatment options have evolved over the years, from cast immobilization to closed reduction fixation and now finally open reduction fixation is used as a better treatment option. Open reduction internal fixation provides excellent fixation to the fracture site and helps in achieving a stable joint that help in early mobilization of the elbow joint after trauma. Which also prevents late complications such as myositis ossificans. This is a case report of capitellar fracture, a typical type -1 Hahn-Steinthal fracture of left elbow joint in a 14 year old adolescent male treated using Herbert’s screw fixation. Here after three months of post-op follow-up it shows good interfragmental compression, early mobilization, excellent recovery & Implant removal is rarely necessary.

Compressed Sensing Image Reconstruction of Ultrasound Image for Treatment of Early Traumatic Myositis Ossificans of Elbow Joint by Electroacupuncture.

This article conducts a retrospective analysis of 500 patients with posttraumatic elbow dysfunction admitted to our department from March 2019 to September 2020. The average time from injury to operation is 11 months (2–20 months). We adopt a personalized treatment method to completely remove the hyperplastic adhesion tissue and heterotopic ossification around the joint, remove part of the joint capsule and ligament, and release it to achieve maximum function. After the operation, an external fixator was used to stabilize the loosened elbow joint, and the patient was guided to perform rehabilitation exercises with the aid of a hinged external fixator, and celecoxib was used to prevent heterotopic ossification. Mayo functional scoring system was used to evaluate the curative effect before and after surgery. The rapid realization of ultrasound imaging under the framework of compressed sensing is studied. Under the premise of ensuring the quality of ultrasound imaging reconstruction, the theory of ultrasound imaging is improved, and a plane wave acoustic scattering ultrasound echo model is established. On this basis, the theory of compressed sensing is introduced, the mathematical model of compressed sensing reconstruction is established, and the fast iterative shrinkage thresholding algorithm (FISTA) of compressed sensing reconstruction is improved to reduce the computational complexity and the number of iterations. This article uses FISTA directly to reconstruct medical ultrasound images, and the reconstruction results are not ideal. Therefore, a simulation model of FISTA training and testing was established using the standard image library. By adding different intensities of noise to all images in the image library, the influence of noise intensity on the quality of FISTA reconstructed images is analyzed, and it is found that the FISTA model has requirements for the quality of the images to be reconstructed and the training set images. In this paper, Rob's blind deconvolution restoration algorithm is used to preprocess the original ultrasound image. The clarity of the texture details of the restored ultrasound image is significantly improved, and the image quality is improved, which meets the above requirements. This paper finally formed a reconstruction model suitable for ultrasound images. The reconstruction strategy verified by the ultrasound images provided by the Institute of Ultrasound Imaging of a medical university has achieved a significant improvement in the quality of ultrasound images.

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.

Myositis ossificans: a short review

Myositis ossificans: a short review

Myositis ossificans: a short review

Myositis ossificans: a short review

Expert Consensus on the Contraindications and Cautions of Foam Rolling-An International Delphi Study.

Background: Foam rolling is a type of self-massage using tools such as foam or roller sticks. However, to date, there is no consensus on contraindications and cautions of foam rolling. A methodological approach to narrow that research gap is to obtain reliable opinions of expert groups. The aim of the study was to develop experts’ consensus on contraindications and cautions of foam rolling by means of a Delphi process. Methods: An international three-round Delphi study was conducted. Academic experts, defined as having (co-) authored at least one PubMed-listed paper on foam rolling, were invited to participate. Rounds 1 and 2 involved generation and rating of a list of possible contraindications and cautions of foam rolling. In round 3, participants indicated their agreement on contraindications and cautions for a final set of conditions. Consensus was evaluated using a priori defined criteria. Consensus on contraindications and cautions was considered as reached if more than 70% of participating experts labeled the respective item as contraindication and contraindication or caution, respectively, in round 3. Results: In the final Delphi process round, responses were received from 37 participants. Panel participants were predominantly sports scientists (n = 21), physiotherapists (n = 6), and medical professionals (n = 5). Consensus on contraindications was reached for open wounds (73% agreement) and bone fractures (84%). Consensus on cautions was achieved for local tissue inflammation (97%), deep vein thrombosis (97%), osteomyelitis (94%), and myositis ossificans (92%). The highest impact/severity of an adverse event caused by contraindication/cautions was estimated for bone fractures, deep vein thrombosis, and osteomyelitis. Discussion: The mechanical forces applied through foam rolling can be considered as potential threats leading to adverse events in the context of the identified contraindications and cautions. Further evaluations by medical professionals as well as the collection of clinical data are needed to assess the risks of foam rolling and to generate guidance for different applications and professional backgrounds.

Case Report: Unusual Presentation of Myositis Ossificans of the Elbow in a Child Who Underwent Excessive Postoperative Rehabilitation Exercise

Traumatic myositis ossificans (MO) is an unusual complication after muscle injury and is predominantly seen in young adults and adolescents. Pediatric MO cases are even rarer. We report an 8-year-old girl who was diagnosed with a lateral humeral condyle fracture. She was treated surgically, and her elbow joint was fixed with plaster. Rehabilitation exercise was administered 1 month after the operation. Due to the wrong exercise method, a palpable bony mass appeared around the elbow 1 month later. The clinical radiological diagnosis showed MO, and conservative treatment was administered. After 3 years of follow-up, the affected limb functioned well, with no sign of recurrence. Here, we report this long-term follow-up case of MO resulting from excessive rehabilitation exercise.

Are open surgery and total resection good choices for traumatic myositis ossificans in children?

Traumatic myositis ossificans is a self-limited, non-neoplastic, ectopic bone formation in the soft tissues caused by trauma. Conservative treatment is the mainstay of management. However, open surgery and complete resection should be considered in patients with limited joint function and constant pain. Herein, we retrospectively analyzed the outcome of open surgical resection in children with myositis ossificans (MO). The data of patients diagnosed with MO between February 2010 and May 2019 were retrospectively analyzed. The clinical data included medical history, physical examination, and laboratory, imaging, and pathological findings. All patients underwent an open surgery and total resection. Radiography findings and joint function were evaluated. Patients with developing complications, such as recurrence and assessing joint function, were followed up. In total, 20 patients (sex, 15 male and 5 female patients; age, 8.1 ± 2.5years) were included. MO was located around the elbow, wrist, proximal humerus, and thigh in 13, one, one, and five patients, respectively. All patients were followed up for > 12months. Two patients had partial recurrence after surgery. One patient with forearm MO had poor elbow function (Broberg-Morrey score of 70). Nineteen patients had good functional outcomes according to the Broberg-Morrey and Cooney methods. Open surgical resection is an effective method for children with MO. The recurrence rate was low when the surgery was performed after the acute stage (1.5months from disease presentation).

Efficacy of ultra-early rehabilitation on elbow function after Slongo\u2019s external fixation for supracondylar humeral fractures in older children and adolescents

ObjectiveTo evaluate the efficacy of ultra-early rehabilitation on elbow function after Slongo’s external fixation for supracondylar humeral fractures in older children and adolescents.MethodsWe retrospectively analyzed clinical data from 49 older children (> 8 years) and adolescents with supracondylar humerus fracture who were treated with Slongo’s external fixation in our hospital from January 2016 to August 2020. Twenty-three patients received ultra-early postoperative rehabilitation (rehabilitation group) and 26 patients were not subjected to postoperative rehabilitation (control group). Time to ROM required for functional activity of daily living(ROM-ADL) in both groups was recorded postoperatively. Patients were followed up at 3 and 6 months after surgery to compare the elbow range of motion (ROM) and carrying angle (CA). Postoperative complications were assessed in both groups. Flynn scores and modified Mayo Elbow Performance Scores were also performed.ResultsThe elbow function at 6 months after surgery was significantly better than that at 3 months in the control group (P = 0.32). Time to ROM-ADL in the rehabilitation group was significantly shorter than that of the control group (P = 0.028). The elbow function, Flynn scores, and modified Mayo scores in the rehabilitation group at 3 and 6 months after surgery were significantly better than that of the control group (P(ROM, 3 months and 6 months) = 0.012 vs 0.039; P(Flynn scores, ROM, 3 months and 6 months) = 0.028 vs 0.005; P(Flynn scores, CA, 3 months and 6 months) = 0.032 vs 0.026; P(Modified Mayo scores, 3 months and 6 months) = 0.039 vs 0.024; respectively). There were no iatrogenic injuries, secondary fracture displacements, myositis ossificans, elbow deformities, or other complications in either group. One case of nail tract infection occurred in the rehabilitation group and was cured.ConclusionSlongo’s external fixation is a safe and effective surgical treatment for supracondylar humeral fractures in children over 8 years old and adolescents. Ultra-early rehabilitation treatment for postoperative children can significantly speed up the recovery after surgery.

Role of MRI in the differentiation of early myositis ossificans and soft-tissue sarcoma

Myositis ossificans (MO) is a benign, self-limiting condition characterized by abnormal ossification of soft tissue. MO occurs most commonly in the setting of trauma, however can also develop spontaneously. A peripheral rim of zonal calcification within the affected region represents the classic late-stage appearance and is considered virtually pathognomonic. During the early stages of MO development, diagnostic uncertainty may, however, arise as its imaging features can demonstrate overlap with malignant lesions such as soft-tissue sarcoma. This may lead to unnecessary further investigations, including image-guided biopsy. Recognition of the imaging features of early MO using magnetic resonance imaging (MRI) can provide the radiologist with more diagnostic certainty and help obviate the need for unnecessary investigation of this benign entity. This case offers an example of how MRI can achieve this diagnosis during the early multimodality investigation of an indeterminate soft-tissue mass.

Bone Scanning Findings in a Patient with Heat Stroke–Induced Rhabdomyolysis

We present a case that caused a diagnostic dilemma on a bone scan. We also review the broad spectrum of nonmalignant findings that can impact the interpretation of a bone scan and the value of correlative imaging using SPECT/CT for exact localization and characterization of lesions. The imaging features of important benign pathologies-that is, metastatic mimics-are elaborated so that the reader can avoid misinterpretations when reporting them. We elucidate 4 uncommon benign findings on a bone scan. Rhabdomyolysis is a result of lysis of skeletal muscle with release of cell contents, such as myoglobin and muscle enzymes, and is diagnosed mostly through a combination of clinical appearance and laboratory values. Myositis ossificans is the most common form of heterotopic ossification, usually occurring within large muscles. Its importance stems largely from its ability to mimic more aggressive pathologic processes. Myositis ossificans is one of the skeletal "do not touch" lesions. Such bone lesions are defined by characteristic imaging features, the identification of which precludes the need for additional diagnostic tests or biopsies, thereby avoiding unnecessary interventions. Acute tubular necrosis is kidney injury caused by damage to the kidney tubule cells (kidney cells that reabsorb fluid and minerals from urine as it forms). Common causes are low blood flow to the kidneys, drugs that damage the kidneys, or a severe underlying infection.

The role of acetic acid in orthopaedic surgery.

Acetic acid has become more commonly used in orthopaedic surgery. The purposed roles include biofilm eradication and surgical debridement, postoperative scar reduction and managing soft tissue injuries. Current research is scarce and does not provide conclusive evidence behind acetic acid’s efficacy in orthopaedic procedures such as biofilm eradication or acetic acid iontophoresis in soft tissue injuries. Current literature on acetic acid’s effects on biofilm eradication is composed of in-vitro studies, which do not demonstrate the potential clinical efficacy of acetic acid. Acetic acid iontophoresis is a novel technique which is now more commonly accepted for soft tissues injuries. Our literature search identified calcifying tendonitis of the shoulder, rotator cuff tendinopathy, heel pain syndrome, plantar fasciitis, achilles tendonitis, calcifying tendonitis of the ankle, myositis ossificans and cervical spondylosis as documented clinical uses. In this narrative review, we present the current uses of acetic acid and acetic acid iontophoresis, while evaluating the evidence revolving around its efficacy, benefits and risks.

Post-traumatic myositis ossificans: a benign lesion that simulates malignant bone and soft tissue tumours.

Myositis ossificans (MO) is a benign bone formation in an extra-skeletal location. The most common subtype of MO, the post-traumatic, usually develops in young males after a traumatic event or sports injury.MO may simulate malignant bone lesions such as extra-skeletal or surface osteosarcomas, or soft tissue sarcomas such as synovial sarcoma or undifferentiated pleomorphic sarcoma. In the early phase the diagnosis of MO is challenging because imaging and histopathological findings may be non-characteristic.Detailed medical history as well as clinical examination, follow-up imaging studies and histological assessment are crucial for a proper diagnosis. Early and accurate differential diagnosis between MO and malignant soft tissue and bone tumours is important to maximize.Cite this article: EFORT Open Rev 2021;6:572-583. DOI: 10.1302/2058-5241.6.210002

Heterotopic Ossification of the Mesentery: A Rare Postoperative Complication

Abstract Heterotopic ossification is a rare, reactive condition, sometimes classified as a “pseudotumor,” involving the formation of bone within the soft tissues (Int J Surg Case Rep 2014;5:476–479), This process can occur as an undesirable pathologic sequela of trauma and surgery (J Am Acad Orthop Surg 2004;12:116–125). The few cases reported in the literature are almost exclusively in men with a predominance in people of African ancestry (J Am Acad Orthop Surg 2004;12:116–125; Bone Joint J 2016;98-B:761–766; Case Rep Surg 2019;2019:4036716). Reports of heterotopic ossification have been described in medical literature since 1692 as myositis ossificans progressiva (JBJS 1938;20:661–674). It was not until 1999 that the term “heterotopic mesenteric ossification” was formally used by Wilson et al to describe a complication found in post–abdominal surgical patients (Am J Surg Pathol 1999;23:1464–1470). Although the exact pathologic mechanism of heterotopic mesenteric ossification has not been elucidated, some hypotheses include differentiation of mesenchymal progenitor cells toward an osteogenic lineage, as well as proliferation of dislocated fragments of bone from other regions of the body (J Gastrointest Surg 2015;19:579–580). Since the late 1900s, fewer than 40 cases of mesenteric ossification have been reported. Limited gross and histologic description is available for pathologists and surgeons to identify this phenomenon; however, further data can be acquired at autopsy. Awareness of this condition on the part of clinicians, and early review and recognition by pathologists, may alter surgical management decisions and improve upon morbidity and mortality in these patients. We present gross and histologic examination of an advanced case of heterotopic ossification at autopsy, with a review of current management recommendations.

Post-traumatic Pain: Think of Circumscribed Myositis Ossificans

Myositis ossificans is a benign condition, essential to know because the presence of ossifications of the soft tissues adjacent to the bone, always makes one fear a neoplastic localization in a young patient. We report in this study a rare case of traumatic circumscribed myositis ossificans of the thigh. Imaging plays an important role in the positive diagnosis, the differential diagnosis and the follow-up of the characteristic three-phase evolution of MOC. However, this pseudotumor may appear clinically and radiologically as a malignant tumor, a thorough knowledge of clinical and morphological study is necessary to differentiate this lesion from a soft tissue malignancy.