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PubMed2001

A young athlete with myositis ossificans of the neck presenting as a soft-tissue tumour.

Myositis ossificans is usually the result of direct injury to a muscle and is a self-limiting disease. It may present as a soft-tissue mass with a broad differential diagnosis, including highly malignant tumours, such as soft-tissue sarcomas. Many theories can be found concerning the aetiology of myositis ossificans, but minor or major traumas are considered to be the most common cause. A unique case of myositis ossificans of the neck in a 17-year-old professional, female, ground gymnast, who presented initially with a soft-tissue tumour, was treated successfully. The main differential diagnosis is presented along with typical radiographic features on conventional radiography, computerised tomography and magnetic resonance imaging, and typical pathological appearance, such as the pathognomonic "zoning phenomenon". Myositis ossificans should be added to the differential diagnosis of every young patient who engages in sport presents with a soft-tissue mass. Careful padding of the area and teaching the rolling technique to avoid repeated injuries to the neck can prevent recurrence.

Adolescent↗
PubMed1982

Myositis ossificans: radiologic evaluation of two cases with diagnostic computed tomograms.

Although most physicians associated myositis ossificans with recent, acute trauma, only 40%-60% of patients give such a history. The appearance of a soft tissue mass without a clear history of trauma may suggest a diagnosis of sarcoma, especially because results of a biopsy of the central portion of an area of myositis ossificans may yield immature, undifferentiated tissue resembling a sarcoma. Pain and rapid growth of a mass are more usual in myositis ossificans than in sarcomas, and careful inquiry may reveal stretching injury or chronic trauma associated with normal, vigorous, physical activities. Recognizing the characteristic histologic zoning phenomenon (immature tissue centrally surrounded by more mature tissue and a peripheral shell of benign bone) during the biopsy procedure permits the correct diagnosis of myositis ossificans. Plain radiographs or conventional tomograms may reflect this histologic zoning by demonstrating the typical, mature, outer shell of bone. Although additional radiographic studies are not usually necessary, they may be obtained when the mass is suspected to be a sarcoma. In two patients computed tomographic scans clearly demonstrated well-defined, peripheral shells of mature bone, diagnostic of myositis ossificans.

Adolescent↗
PubMed1985

Myositis ossificans progressiva and pregnancy. A therapeutic dilemma.

Myositis ossificans progressiva is a rare but progressively debilitating autosomal dominant disease characterized by extraskeletal ossification involving muscle connective tissue. This report is the first on pregnancy and induced abortion in a patient with myositis ossificans progressiva. Intraoperative sector scanning ultrasound was of limited benefit in evacuation of the uterine cavity. Conservative management of an incomplete termination resulted in no adverse sequelae.

Abortion, Induced↗
PubMed1997

Myositis ossificans: an unusual presentation in the foot.

Myositis ossificans is a non-neoplastic lesion characterized by heterotopic ossification of soft tissue. At varying stages of maturity, it shares similar histologic characteristics with sarcomatous lesions or maturing bone. Misdiagnosis can result in unnecessary radical treatment. This lesion has only rarely been reported in the foot. We present the case of a patient with plantar forefoot myositis ossificans.

Adolescent↗
PubMed1995

[Traumatic myositis ossificans. Posttraumatic non-neoplastic heterotopic ossification].

Myositis ossificans traumatica (MOT) is a nonneoplastic, heterotopic ossification of soft tissues i.e. skeletal muscle, tendons, aponeuroses and fascia. It is often encountered in young male athletes participating in contact sports as a result of a single or repeated contusion. MOT tends to be solitary, localized and well circumscribed with a self-limited growth potential that may culminate in regression. The pathogenesis of MOT is still enigmatic. Recent animal experiments have led to a theory that mesenchymal connective tissue cells, undergo metaplasia induced by trauma and probably osteogenic proteins, to fibroblasts and osteoblasts. These cells deposit and structure osteoid centripetally in the lesion. As the lesion matures, cancellous bone develops into mature, lamellar bone in the periphery of the lesion. In its earlier stages MOT is easily cytologically and radiologically confused with osteogenic sarcoma. The management of MOT is largely conservative and the principles are of considerable value to physicians and physiotherapists engaged in the treatment of sports injuries. This article reviews the various forms of myositis ossificans as well as the pathology, diagnosis and treatment options.

Adolescent↗
PubMed2004

[Myositis ossificans circumscripta in the axilla].

Myositis ossificans circumscripta (MOC) is a rare benign hereditary disorder characterized by heterotopic bone formation in soft tissue and muscle. This disorder is rarely seen in childhood. MOC is most commonly located in the extremities. We describe a 15-year-old girl with nontraumatic MOC in the axilla. Imaging studies (radiographic, ultrasound) did not provide the correct diagnosis and did not rule out malignancy. Incisional biopsy of the mass and histopathologic examination gave the diagnosis of MOC. Some reports suggest that magnetic resonance imaging may be the first-choice diagnostic option and may avoid unnecessary biopsy. However, in many cases diagnosis is still histological. Differential diagnosis between these lesions and malignant sarcomas and fibrodysplasia ossificans progressiva is required. This entity has a good prognosis in childhood.

Adolescent↗
PubMed1985

Resolution of myositis ossificans in a hemophiliac.

Hemophilic myositis ossificans at the site of previous hemorrhage is a well recognised entity. A phenomenon, not previously described, is gradual absorption of a well corticated heterotopic bone over a period of five-and-a-half years. We here report this happening in a patient.

Child↗
PubMed1989

Fibrodysplasia (myositis) ossificans progressiva in Dominica.

Fibrodysplasia (myositis) ossificans progressiva is a rare but severely disabling disease in which ossification forms within muscle and leads to progressive restriction of the movements of the jaw, neck, shoulders and hips. Shortening of the big toes is usually present. It is important to recognise this disease as avoidance of intra-muscular injections, surgery and trauma reduces the risk of further ossification.

Adult↗
PubMed2005

Non-traumatic myositis ossificans in the paraspinal muscles.

Myositis ossificans circumscripta (MOC) is a benign condition of heterotopic bone formation that remains difficult to distinguish from soft-tissue and bone malignancies. We describe an unusual case of non-traumatic MOC in the cervical paraspinal muscle. The diagnosis could only be established after surgery and histological examination. We present a review of the literature on this subject and discuss some related features (radiological and histological).

Adult↗
PubMed1997

[Myositis ossificans circumscripta and its variants].

Myositis ossificans circumscripta (MOC) is a benign proliferation of fibrous tissue with large amounts of bone within soft tissues. Its clinical and radiological course is described and the value of CT and MR imaging is emphasized. Differential diagnosis includes soft tissue hematoma, infection or tumor. Florid reactive periostitis of the phalanges, turret exostosis, bizarre periosteal osteochondromatous proliferation in the hand and fibro-osseous pseudotumor of the digits are also described.

Biopsy↗
PubMed1993

Chronic intoxication by ethane-1-hydroxy-1,1-diphosphonate (EHDP) in a child with myositis ossificans progressiva.

A child with myositis ossificans progressiva was treated for 8 years with ethane-1-hydroxy-1,1-diphosphonate (EHDP) 30-40 mg/kg per day. Latterly he complained of severe, progressive bone and joint pain which made standing and walking almost impossible. A radiographic skeletal survey showed diffuse ricket-like lesions. Withdrawal of EHDP therapy produced substantial improvement in his general condition as well as in the radiographic appearance of the bones. Multiple exostoses were observed in this case and, particularly those around the knees, presented a peculiar morphology. This supports the theory that exostoses originate from a defect of metaphyseal modelling.

Adolescent↗
PubMed1991

Myositis ossificans: MR appearance with radiologic-pathologic correlation.

We reviewed retrospectively the MR images of eight histologically proved cases of myositis ossificans and correlated the MR appearance with the histologic findings, as well as with other radiologic studies. Patients with available MR images were chosen from a group of 326 cases in our radiologic archives of histologically proved and radiologically correlated myositis ossificans. In addition to MR images, all patients had plain radiographs, six had CT scans, and two had arteriograms. On T2-weighted spin-echo MR, the lesions were relatively well defined and inhomogeneous and had intermediate to high signal intensity. The latter corresponded to a central proliferating core of fibroblasts and myofibroblasts with a myxoid stroma resembling nodular fasciitis, rimmed by osteoblasts with bone production. Edema surrounded lesions less than a few months old. T1-weighted images of early lesions were normal or showed evidence of a mass by displacement of fat planes. Hemorrhage and fluid-fluid levels were seen in one lesion of intermediate duration. Mature lesions tended to be well defined with inhomogeneous signal intensity, similar to that of fat, representing areas of fat situated between bone trabeculae within the lesion. We present the MR appearance of myositis ossificans and correlate it with other radiologic studies and the histologic findings. The varying appearance of myositis ossificans relates to the histologic changes that occur as the disorder progresses. Knowledge of the MR appearance of myositis ossificans is important in that the lesion has many of the MR imaging characteristics frequently associated with malignancy.

Adolescent↗
PubMedDate not supplied

[Myositis ossificans in recurrent synovial hemangioma of the knee].

A case of myositis ossificans in 15-year old boy that occurred as a complication of the recurrent synovia hemangioma of the left knee was presented. The alteration was diagnosed as: osteosarcoma, chondrosarcoma and chondromyxoid fibroma by the pathologists from other institutions. The diagnosis of myositis ossificans was established using numerous histochemical and immunochemical methods (PAS, PAS diastasis, Alcian blue, Masson trichrom, von Kossa, Azur A, Toluidin blue, Goldner, method by Peris, Citokeratin, S-100, NSE and Vimentin). The presence of zonal phenomenon, as the one observed in the presented case, is one of the most significant criteria for differentiation of myositis ossificans from osteosarcoma.

Adolescent↗
PubMed1995

Generalized periarticular myositis ossificans as a complication of pharmacologically induced paralysis.

To our knowledge, no previous direct associations have been made between generalized myositis ossificans and pharmacological therapy. We report a case of generalized periarticular myositis ossificans associated with the use of curare and diazepam. The previously reported associations of myositis ossificans with tetanus and burns may be misleading. It is possible that it is not the disease process itself (e.g., tetanus, severe burn) that precipitates heterotopic ossification, but the treatment of these ailments. These observations suggest the importance of early mobilization and restrained use of immobilizing drugs. Further investigation is warranted with regard to the predisposing factors of generalized myositis ossificans and to its prevention.

Adult↗
PubMed1986

Traumatic myositis ossificans in masticatory muscles.

3 cases of traumatic myositis ossificans circumscripta, located within the masticatory muscles are presented. Two of the lesions involved the masseter muscle, and exceptionally, 1 involved the temporalis muscle. Three pathognomonic histological zones, permitting the differential diagnosis of myositis ossificans from sarcomatous lesions, are described, and treatment incorporating ideally early surgical intervention with wide excisional biopsy of the lesion is stressed.

Adolescent↗
PubMed1992

Treatment of traumatic myositis ossificans with acetic acid iontophoresis.

The purpose of this case report is to document the treatment of a patient who had traumatic myositis ossificans with acetic acid iontophoresis. A 16-year-old boy developed quadriceps femoris muscle myositis ossificans as a result of a springboard diving accident. A 2% acetic acid solution was administered via iontophoresis into the myositis ossificans, followed by 8 minutes of pulsed ultrasound at 1.5 W/cm2. The treatment was performed three times per week for 3 weeks. At the conclusion of the treatments, radiographic findings indicated a 98.9% decrease in the size of the ossified mass. The patient regained full range of motion and was able to return to pain-free activity. This case report demonstrates the potential for a therapeutic program of acetic acid iontophoresis and ultrasound in eliminating myositis ossificans.

Acetates↗