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Results for “MYOSITIS OSSIFICANS”

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PubMed1987

Circumscribed spontaneous heterotopic ossification in the soft tissues simulating sarcoma.

Eight cases are described of circumscribed heterotopic ossification in the soft tissues characterised by spontaneous onset, no history of trauma, and rapid course which have frequently led to a mistaken preoperative diagnosis of highly malignant tumour. The terminology differentiates it from myositis ossificans, which is a different entity. The authors emphasize the need for accurate evaluation of all the clinical and radiographic data in order to avoid an erroneous diagnosis of extraosseous osteogenic sarcoma or parosteal osteogenic sarcoma. In this regard, both radiography and histological examination demonstrate the so-called zoning pattern, namely a radiolucent central zone corresponding to the more immature area and consisting of fibrous tissue with active histiofibroblastic proliferations and a radiopaque peripheral area, where ossification is more mature the closer it gets to the periphery. Histological specimens obtained exclusively from the central area may lead even the most expert pathologists to a diagnosis of fibrosarcoma or osteogenic sarcoma. Finally, the pathogenetic aspects of the anomaly are discussed, as well as those concerned with the differential diagnosis from other types of heterotopic ossification.

Adolescent↗

PubMed1991

[Bony bridges of the lumbar transverse processes].

A traumatic osseous bridge between lumbar transverse processes is a bone formation occurring after severe or even mild trauma of the back. However, only few of the patients with a contusion of the back or a fracture of a lumbar transverse process develop such an osseous bridge. The localisation of the haematoma plays an important role in this process, but myositis ossificans is a mandatory condition. Anamnesis will not lead to traumatic aetiology in all cases, because sometimes the patient is not aware of the fact that a transverse process has been fractured. The diagnosis finally depends on the recognition of the different shapes. The traumatic osseous bridge is characterised by the kind of trauma that causes the fracture of the transverse process. The shapes can be classified as "h", "H", "K", or "Z". Among 72 patients with inter-transverse osseous bridges, only 11 patients have congenital bridges. The congenital osseous bridge shows typical features that can be explained by means of embryogenic and functional dynamic considerations. These symptoms are the O-shape, concavity of the lumbar spine of a pathological nature and the absence of degenerative changes in the corresponding intervertebral space.

Adult↗

PubMed1975

Heterotopic ossification in spinal cord-injured patients.

Therapy programs during the development of heterotopic ossification in spinal cord injury range widely from complete rest to aggressive exercise programs. The literature is confusing by its multiplicity of recommendations because the basic etiology and pathophysiology are unknown and because some basic differences exist between traumatic myositis ossificans and heterotopic ossification associated with severe neurological impairments. Prospective heterotopic ossification roentgenographic (x-ray) surveys of the hips, knees, shoulders, and elbows were made on 250 consecutive spinal cord-injured patients. Those who had x-ray evidence of early or immature heterotopic ossification or who developed early clinical signs of possible heterotopic ossification were treated with an aggressive program of passive progressive range of motion exercises. Several patients who developed bilateral heterotopic ossification had one side used as their own control. Follow-up x-ray studies and range of motion evaluation suggest that an aggressive range of motion exercise program is indicated for patients who are developing or have heterotopic ossification. There is no evidence that exercise increases inflammation with subsequent ossification, and it frequently causes a pseudarthrosis, permitting adequate functional range of motion.

Adolescent↗

PubMed1995

A review of 40 patients with extraskeletal osteosarcoma.

BACKGROUND: Extraskeletal osteosarcomas are rare malignancies that account for about 1% of all soft tissue sarcomas. Few large series have been reported. METHODS: Clinical records and histologic slides of all patients with extraskeletal osteosarcomas treated at the Mayo Clinic between 1915 and 1988 were reviewed. RESULTS: The study group consisted of 40 patients, most of whom presented in the sixth and seventh decades of life (mean age, 50.7 years). There was a male predominance (male-to-female ratio, 1.9:1). The lower limbs most commonly were involved (68%), usually the thigh and buttock regions. Ninety-three percent of tumors presented as an enlarging soft tissue mass, with a history of trauma in nine patients. In nine patients, the lesions were initially interpreted histologically as benign, most commonly as myositis ossificans. Histologically, all were high grade osteosarcomas. Multiple local recurrences (45%) are a feature of this tumor. All recurrences occurred within 3 years. Distant metastasis (65%) is also common and is usually to the lungs (81%). Radical resections appear to be the best option for local control, with resection of the pulmonary metastasis occasionally producing a cure. By univariate analysis of Kaplan-Meier survival curves, the patients with predominantly chondroblastic tumors fared better than those with predominantly osteoblastic tumors (P = 0.03). Analysis of survival differences of the three main subtypes together (osteoblastic, chondroblastic, and fibroblastic) was not significant. A small-sized initial lesion did not equate with better survival. Seventy-three percent died of the disease, with a mean follow-up of 5.9 years. CONCLUSION: Extraskeletal osteosarcoma is a high grade malignant tumor associated with a 5-year survival rate of 37% (95% confidence interval, 28%-59%). Local recurrences and distant metastasis are common and usually occur by 3 years after excision. Patients with the chondroblastic subtype survive longer than those with the osteoblastic subtype.

Adult↗

PubMed2000

Heterotopic ossification in childhood and adolescence.

Heterotopic ossification, or myositis ossificans, denotes true bone in an abnormal place. The pathogenic mechanism is still unclear. A total of 643 patients (mean age, 9.1 years) admitted for neuropediatric rehabilitation were analyzed retrospectively with respect to the existence of neurogenic heterotopic ossification. The purpose of this study was to obtain information about incidence, etiology, clinical aspect, and consequences for diagnosis and therapy of this condition in childhood and adolescence. Heterotopic ossification was diagnosed in 32 patients (mean age, 14.8 years) with average time of onset of 4 months after traumatic brain injury, near drowning, strangulation, cerebral hemorrhage, hydrocephalus, or spinal cord injury. The sex ratio was not significant. In contrast to what has been found in adult studies, serum alkaline phosphatase was not elevated during heterotopic ossification formation. A persistent vegetative state for longer than 30 days proved to be a significant risk factor for heterotopic ossification. The incidence of neurogenic heterotopic ossification in children seems to be lower than in adults. A genetic predisposition to heterotopic ossification is suspected but not proven. As a prophylactic regimen against heterotopic ossification we use salicylates for those patients in a coma or persistent vegetative state with warm and painful swelling of a joint and consider continuous intrathecal baclofen infusion and botulinum toxin injection for those patients with severe spasticity. We prefer to wait at least 1 year after trauma before excision of heterotopic ossification.

Adult↗

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