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[Multilocular myositis ossificans--damage caused by excessive stress in performance sports?].

This is a report of a girl of 16 years of age who complained of pain in both legs after intensive competitive sports, the main event being the 800 m race. Radiologically visualised were periostal reactions and new periostal bone formations at the femur and lower leg. Diagnosis was extremely difficult due to generalised signs and symptoms, such as temperature, associated with inappetence and a "run-down" feeling, increase of alkaline phosphatase and liver enzyme levels and of the blood sedimentation rate. Differential diagnosis of heterotopic ossifications is dealt with in detail.

Adolescent↗

Atypical arteriographic features of myositis ossificans circumscripta (MOC).

Earlier reports on the angiographic features of MOC concluded that there may be hypervascularity and tumor stain but no A-V shunting, pooling, or vessel amputation as a result of the lesion. However, our cases demonstrated A-V shunting in MOC, and showed that the vascularity of this lesion can closely mimic that of malignant neoplasms. Therefore, the possibility of MOC should not be excluded because of the presence of A-V shunts or "tumor vessels" in suspected MOC lesion on plain radiography. These points are underscored by the findings in two MOC patients, whose cases are described.

Adult↗

[Catatonia, malignant neuroleptic syndrome and myositis ossificans].

Lethal catatonia and the malignant neuroleptic syndrome represent two potentially fatal disorders that require different therapeutic regimens. Clinical differentiation is considered difficult because of a number of similarities with respect to mode of onset, signs and symptoms, and outcome. Recent observations emphasizing similarities between the two disorders, however, suggest that catatonia and the malignant neuroleptic syndrome may not represent separate diagnostic entities. Instead, the malignant neuroleptic syndrome has been hypothesized to be a neuroleptic-aggravated form of catatonia. In the present paper, we report the case of a 22-year-old male who developed different forms of malignant neuroleptic syndromes subsequent to a catatonic episode and overlapping it. In addition, the course was complicated by the occurrence of heterotopic calcification within skeletal muscles. The clinical value of diagnostic criteria that help distinguish catatonia from neuroleptic malignant syndrome and their therapeutic consequences are discussed.

Adult↗

[Myositis ossificans generalisata or calcinosis interstitialis universalis, a difficult differential diagnosis].

Palpable indurations, calcified nodules, osseous plates and clasps in shoulder, upper arms, thighs and in the back and pelvis muscles are typical signs for several progressive diseases or are associates with some systemic diseases of youth. These changes imply greatly decreased range of motion of all limb joints and increasing retardation of growth and development and often lead to early death. Although often described, the etiology of these diseases is not known. We observed some years ago a particularly serious case, where the connective tissue of almost all the muscles of the skeleton, the subcutis and the ligaments of the limb joints were penetrated by amorphous calcifications and moreover ectopic ossifications were seen in the perirenal adipose tissue and in the interstitial adipose and connective tissue of the striped muscles. Ossifications and calcifications respectively are typical for different diseases, and therefore in our described case it was difficult to decide for a definitive diagnosis.

Calcinosis↗

Fibrodysplasia (myositis) ossificans progressiva treated with disodium etidronate.

Two patients with fibrodysplasia ossificans progressiva (FOP) were treated with disodium etidronate, a disodium salt of ethane-1-hydroxy-1, 1-diphosphonic acid (EHPD) for two years; both had multiple ectopic ossifications of connective tissue. Regular follow-up showed no improvement in joint movement whilst laboratory examination revealed an increase in the serum phosphorus level. Serum calcium and urinary phosphorus excretion remained within normal limits. The urinary calcium excretion varied with the dose of EHDP. X-ray examination showed significant reduction in size and density of the ectopic ossifications, while the density of bones during and after EHDP therapy remained normal. Development of new ossification was inhibited in the active phase of the disease. Suspected side-effects of the drug were occult blood in stools, skin petechiae, and amenorrhoea. Previous reports on the EHDP treatment of disorders with ectopic ossification are summarised.

Adult↗

Fibrodysplasia (myositis) ossificans progressiva.

Fibrodysplasia ossificans progressiva (FOP) is a rare hereditary connective tissue disorder. Patients with FOP develop progressive ossification of muscle and connective tissue associated with pain and disability. Onset is typically in childhood, and congenital anomalies of the feet are an early sign of this condition. Pain and stiffness of the spine or an inflammatory mass are common presenting features of FOP. Involvement of the spine often leads to complete fusion mimicking ankylosing spondylitis. Studies of twins and families suggest that FOP is a genetically inherited autosomal dominant trait with complete penetrance but variable expressivity. While radionuclide imaging and computed tomography are very sensitive for new bone formation and greatly assist the diagnosis of FOP, unfortunately, effective therapy is unavailable. We present twins with FOP and review the clinical, radiographic, and genetic manifestations of this disorder.

Adult↗

Heterotopic mesenteric ossification ("intraabdominal myositis ossificans''): a case report.

Heterotopic ossification has been reported only rarely within the abdominal cavity, specifically in a mesenteric location (heterotopic mesenteric ossification). We describe the case of a 76-year-old man with no history of previous surgery who developed small bowel obstruction associated with multiple foci of heterotopic bone formation within the small bowel mesentery. He underwent small bowel and mesentery resection and is disease-free 9 months later.

Aged↗

The stone man: myositis (fibrodysplasia) ossificans progressiva.

Myositis ossificans progressiva (MOP) is a rare hereditary connective tissue disorder characterized by progressive ossification of striated muscle and connective tissue associated with pain and disability. It is presumably transmitted as an autosomal dominant defect. Congenital anomalies of the hands and feet are early signs of this disease. Involvement of the spine, hips and extremities lead to the development of the "stone man" with only less than 600 cases reported in the literature. We present a case of MOP with typical muscle ossifications and skeletal malformations.

Adult↗

Myositis (fasciitis) ossificans in an infant.

Myositis (fasciitis) ossificans developed following minor trauma to the soft tissues of the posterior aspect of the right knee of a 5-month-old female infant. The clinical and pathological features of myositis ossificans are reviewed and the differential diagnosis of soft tissue ossification in early childhood is discussed.

Female↗

[Localized interstitial calcinosis (author's transl)].

Case report of an unusual case of soft tissue calcification in the lower leg of a 50 year old patient examined for compensation problems for a gunshot fracture suffered in World War II. The differential diagnosis "localized interstitial calcinosis", "myositis ossificans" and "myositis ossificans progressiva" is being discussed.

Calcinosis↗

[Fibromatosis and fibrodysplasia ossificans progressiva. An avoidable diagnostic error].

BACKGROUND: Myositis ossificans progressiva is a rare progressive disease of connective tissue and muscle whose early diagnosis, before the lesions become ossified, can be difficult. The congenital malformations that accompany the disease may help in this diagnosis. CASE REPORT: A 12 year-old boy developed a localized swelling in the right trapezius muscle. Muscle biopsy showed fibromatosis lesions. Surgical excision was incomplete and despite chemotherapy, new lesions appeared periodically in the cervical and dorsal regions where they became ossified. Bilateral hallux valgus was noticed at that time and used to rectify the diagnosis as myositis ossificans progressiva. CONCLUSION: Many children suffering from myositis ossificans progressiva have congenital malformations, most commonly of big toes and thumbs. These anomalies are important for distinguishing myositis ossificans progressiva from other inflammatory diseases of muscle.

Child↗

Myositis ossificans-like lesion of nerve.

An unusual ossifying lesion arising within the median nerve of a young adult male is presented. While ectopic ossification has been described in a large number of sites, intraneural ossification is an uncommon event and usually occurs in association with a pre-existing intraneural neoplasm. This case, in contrast, bears striking histopathological resemblance to myositis ossificans with prominent zonation. We believe that this may represent the first example of a benign myositis ossificans-like lesion of nerve.

Adult↗

A three generation family with fibrodysplasia ossificans progressiva.

A family with five persons affected with fibrodysplasia ossificans progressiva (myositis ossificans progressiva) in three generations is described. This is the first well documented three generation family with this condition and provides further evidence for autosomal dominant inheritance. A wide range of phenotypic severity is apparent, from disabling ectopic bone formation and premature death to an asymptomatic adult with characteristic big toe malformations.

Adolescent↗

Aneurysmal bone cyst and other nonneoplastic conditions.

Aneurysmal bone cyst is a benign proliferative tumefaction of bone. Histologic similarities indicate a kinship among classic aneurysmal bone cysts, essentially "solid" proliferative lesions in bones; giant cell reparative granulomas of the jaws, at the base of the skull, and in the small bones of the hands and feet; skeletal lesions of hyperparathyroidism; and even pseudosarcomatous myositis ossificans, proliferative myositis, and proliferative fasciitis.

Adolescent↗