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Results for “MYOSITIS OSSIFICANS”

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PubMed1991

Exertional muscle injuries: magnetic resonance imaging evaluation.

Exertion-related muscle pain is frequent in athletes and patients alike; however, its severity and significance may be difficult to assess clinically. MRI can be used to evaluate myalgia, strains, delayed-onset muscle soreness, chronic muscle overuse syndromes, muscle contracture, and sequellae of muscle injuries such as myositis ossificans and compartment syndrome. MRI documents the distribution of affected muscles, the presence of focal hematoma, fascial herniation, and subsequent healing, fibrosis, or fatty infiltration. MRI is useful in evaluating acute and delayed exertional muscle injuries.

Athletic Injuries↗

PubMed1990

[The results of a resection intervention in isolated fractures of the radial head].

The results of radial head excision were studied in 33 patients with isolated fracture of the radial head. The follow-up period ranged from 1 to 19 years (mean 9.5 years). Overall results were excellent or good in 25 patients (76%) and fair or poor in 8 patients (24%) with functional limitation of the elbow. Range of motion was greatly limited in those patients who had a myositis ossificans or a radio-ulnar synostosis. Periarticular ossifications were observed in 17 elbows (54%) and subluxation of the inferior radio-ulnar joint in 20 wrists (60%). Excision of the radial head is the treatment of choice for comminuted isolated fractures of the radial head, even if in some patients limited elbow function should be expected.

Adolescent↗

PubMed1990

Heterotopic bone formation after noncemented total hip arthroplasty. Location of ectopic bone and the influence of postoperative antiinflammatory treatment.

The regional-development of heterotopic bone around the hip and the influence of postoperative prophylaxis with antiinflammatory drugs were studied in 66 patients treated with 74 noncemented, porous-coated total hip arthroplasties (THA) using the McFarland approach. Thirty patients (34 hips) were treated with antiinflammatory drugs during the early postoperative period. Heterotopic bone developed in two different regions: central, around the neck of the femoral component, and lateral to the greater trochanter of the femur. Central ossifications were recorded in 53% of the hips and appeared significantly less frequently in patients postoperatively treated with antiinflammatory drugs. Lateral ossifications were recorded in 71% of the hips, and no significant prophylactic effect was found for postoperative antiinflammatory treatment. In response to the McFarland approach in THA, heterotopic ossifications may appear both centrally around the neck of the femoral component and lateral to the trochanter in the substance of the medial gluteal muscle. The latter may be comparable to post-traumatic myositis ossificans.

Adolescent↗

PubMed1990

Acute anterior thigh compartment syndrome complicating quadriceps hematoma. Two case reports and review of the literature.

Acute compartment syndrome of the thigh has been reported infrequently. To date, only eight cases from isolated blunt trauma without fracture have been reported. Two additional cases caused by intramuscular hematomas following blunt, low-energy trauma, which were treated successfully with emergency fasciotomies, are presented. The morbidity from this syndrome varies from mild, with quadriceps weakness, fatigue, and myositis ossificans, to severe, with limb-threatening vascular compromise. Morbidity can be avoided if a high level of suspicion is maintained, compartment pressures are measured, fasciotomies are performed, and hematomas are drained. Postoperatively, patients can expect a dramatic decrease in pain and a quick return of quadriceps function with aggressive physical rehabilitation.

Acute Disease↗

PubMed1990

Tumors about the knee in children.

Tumors are rare causes of knee symptoms in children but must be considered in the differential diagnosis of pediatric knee pain in order to avoid errors in treatment that could result in loss of limb or even life. Experience with 199 bone and soft-tissue tumors about the knee in children are reviewed. The majority of lesions were benign bone tumors (n = 101), with osteocartilaginous exostoses, nonossifying fibromas, and chondroblastomas predominating. Malignant bone tumors (n = 59) were less frequent, and osteosarcoma (n = 48) was by far the most common sarcoma. Soft-tissue lesions (n = 31) were much less frequent and included rhabdomyosarcoma, synovial sarcoma, fibrosarcoma, and desmoid tumors. A careful history, physical examination, and review of roentgenograms are essential to avoid errors in diagnosis. Malignant tumors require roentgenograms and laboratory studies in sequence to stage the patient. A properly performed biopsy established the diagnosis in most instances. Popliteal cysts, stress fractures, infection, myositis ossificans, histiocytosis, and other lesions can mimic tumors and delay correct diagnosis.

Adolescent↗

PubMed1990

Completely displaced supracondylar fracture of the humerus in children. A review of 1708 comparable cases.

The displaced supracondylar fracture of the humerus in children is a very difficult injury to treat. Manipulation and splint immobilization is perhaps the most common method. A review of the literature on 1708 comparable cases revealed that several different treatments were used. The worst results occurred with manipulation and splint immobilization alone. The best results occurred with traction techniques and well-performed Kirschner-pin transfixation, either open or closed. Complications such as Volkmann's ischemic contracture and myositis ossificans are rare. A completely displaced supracondylar fracture in a child should not be treated by manipulation and splint immobilization alone.

Bone Wires↗

PubMed1979

Induction of new-bone formation in the host bed by human bone-tumor transplants in athymic nude mice.

UNLABELLED: Specimens of twelve osteosarcomas, five chondrosarcomas, one giant-cell tumor, and five extraskeletal soft-tissue sarcomas were transplanted into male athymic nude (nu/nu) mice. Survival of the transplant was determined by the volume-doubling time and the sex chromatin of the tumor cells obtained from two female patients. By these criteria and the similarity of the histological composition of the original tumor and the transplant, survival occurred in four of twelve osteosarcomas and four of five chondrosarcomas. Without any local infiltration of lymphocytes or plasma cells, or other evidence of cell-mediated immunity, the surviving tumors regressed by the fourth week after the operation. Transformed osteoblasts and osteoprogenitor cells were replaced by fibrous connective tissue or fibrogenic tumor-tissue cells. Osteocytes degenerated and disappeared from the lacunae. The one giant-cell tumor transplant survived, growing very slowly, but by the end of the first week after transplantation whorls of mononucleated cells appeared in sites previously occupied by multinucleated cells. Transplants of leiomyosarcoma, liposarcoma, and synovioma (one tumor of each) degenerated. One of two fibrosarcomas survived transplantation. The most striking reaction of the mouse host bed was to encompass six of twelve osteosarcomas and four of five chondrosarcomas in deposits of normal living cartilage, bone, and bone marrow. The incidence of new bone inducedy by living transplants was only slightly greater than by implants of freeze-dried killed osteosarcoma tissue. Not one of five extraskeletal sarcomas, living or dead, induced bone formation. These observations suggest that an osteoinductive agent is transmitted by some osteosarcomas and chondrosarcomas. This agent initiates differentiation of host mesenchymal cells into normal non-tumorous cartilage and bone, which later colonized by bone marrow. CLINICAL RELEVANCE: Our observations present experimental evidence of the origin of the envelope of normal non-tumorous bone that may surround tumorous bone. In 1926, Phemister recognized the clinical significane of this envelope as a pitfall in the differential diagnosis of malignant bone tumors, chondrosarcoma, myositis ossificans circumscripta, and other neoplasms. He emphasized the importance of examining the entire specimen for the distribution of deposits of tumorous and normal bone. The induction of normal bone formation in the host bed surrounding transplants of osteosarcomas and some chondrosarcomas (but not transplants of fibrosarcoma, liposarcoma, or leiomyosarcoma) is evidence of a specific tumor-cell characteristic. Thus, the bone inductive response is not an unspecific reaction to injury from expansion or of tumor growth but a biological response to tumor-cell products. Transplants of human malignant tumors growing in the thymus-deficient mouse can be treated by combinations of radiation, amputation, and new chemotherapeutic agents...

Adolescent↗

PubMedDate not supplied

Open bone graft epiphyseodesis for slipped capital femoral epiphysis.

Seventeen patients underwent open bone graft epiphyseodesis for slipped capital femoral epiphysis (SCFE); physeal fusion was achieved in 12 patients. Eight grafts either resorbed, moved, or fractured postoperatively (graft insufficiency). Graft insufficiency was statistically associated with failure of physeal fusion, (p = 0.009). Radiographic examination, using three different measurements, corroborated postoperative changes in femoral head position. One case of joint space narrowing and three cases of significant myositis ossificans occurred. Ten patients had anterolateral thigh hypesthesia. We conclude that fracture, movement, or resorption of a single bone graft is common, leading to an increase in slip severity and failure of physeal fusion.

Adolescent↗

PubMed1989

Resection of the radial capitellum. Long-term results.

The results of 39 resections of the radial capitellum reviewed after an average of 12 years were excellent or good in 59% of the cases and fair or poor in 41%. The results were better in isolated fractures of the capitellum (excellent or good, 71%) compared with those with associated lesions in the same limb (excellent or good, 44%). A reduction of movement was frequently observed, particularly in pronation and supination, which was limited in 28% of the cases and abolished in 15%. In 4 patients there was a significant increase in cubitus valgus. Arthrosis was present in 45% and periarticular calcification in 74% of the cases. There were 5 cases of radioulnar synostosis and 4 cases of myositis ossificans. Subluxation of the distal radioulnar joint was observed in 26 wrists, 4 of which were painful. The results of resection of isolated fractures may be considered acceptable, while the prognosis of fractures with associated lesions is more unfavourable.

Adolescent↗

PubMed1989

[Syndrome of compression of the external saphenous nerve (or the sural nerve)].

The authors describe a new canal syndrome, which they call the "superficial sural aponeurosis canal syndrome" or "sural nerve tunnel syndrome". Mostly seen in sportsmen, it was observed in this case in the context of a myositis ossificans circumscripta of the tendo-muscular junction of the heel. The clinical signs are caused by compression of the sural nerve where it passes through a nonextensible tunnel formed by the fold of the posterior sural aponeurosis. This is distinguished from a loge syndrome; the most typical clinical sign is increased pain in the territory of the sural nerve during plantar flexion of the ankle; in this position reduced sensory conduction velocity is measured. The treatment consists in a section of the fibro-aponeurotic arch.

Female↗

PubMed1989

[Total hip prosthesis according to Charnley. Review of our cases].

This is a follow-up study of 363 Charnley hip replacements out of 548 implanted from 1970 to June 1984. Clinical results, with a 2-year minimum follow-up (average 5 years, maximum 15 years) are excellent or good in 89.5% of the cases. In the group with minimum 5-year follow-up (average 7, maximum 15 years) the clinical results remain good to excellent in 89.2% of the cases. Radiographic results have been studied in the group with minimum 5-year follow-up. Component stability or radiographic loosening have been studied, taking into account the presence of radiolucent lines between bone and cement, between metal and cement, or based on component migration or positional shift. We have detected radiographic loosening in 11.5% of the acetabular and 13.5% of the femoral components. A correlation was sought between radiographic loosening and some clinical (diagnosis, weight, follow-up period) and radiographic (postoperative component position, polyethylene wear, cement technique, periosteal reaction, myositis ossificans) parameters. There is no strong relationship between radiographic loosening and clinical results, as 28 of 35 radiographically loose prostheses maintained excellent or good results. Finally, the results of a selected group of 29 hips, with a minimum follow-up of 10 years, is reported.

Adult↗

PubMed1989

The evaluation of a soft-tissue mass in the extremities.

A soft-tissue mass in an extremity may present a diagnostic dilemma for the evaluating surgeon. A decision either to observe or remove the mass is required. An algorithm can assist in the decision-making process. A careful history may aid in determining the etiology. A history of thigh-muscle trauma, for instance, may suggest myositis ossificans as the diagnosis of a malignant soft-tissue tumor. A large, firm mass that is fixed to deep structures or located within muscle should prompt the following studies: (1) plain radiographs of the extremity; (2) an ultrasound study of the mass; and (3) a three-phase technetium 99m methylene diphosphonate bone scan.

Biopsy↗

PubMed1989

Extraskeletal osteosarcoma in two dogs.

Extraskeletal osteosarcoma (ESOS) of the spleen and jejunum was diagnosed in 2 dogs. As an extremely uncommon type of tumor that has proven difficult to treat, ESOS is associated with high rate of local recurrence and metastatic disease. Extraskeletal osteosarcoma principally affects older dogs, has no apparent breed predilection, and may develop more frequently in males. The cause of ESOS is unknown, but may involve malignant metaplasia of pluripotential mesenchymal cells into osteoblasts. Macroscopically, ESOS usually is observed as a hard mass and may appear similar to calcified hematoma or myositis ossificans. The classic radiographic appearance of ESOS is a soft tissue mass with focal mineralization and without adjacent bone involvement.

Animals↗

PubMed1987

Heterotopic chondro-ossification: a case report.

We report heterotopic chondro-ossification occurring in the hand of a young man in the absence of trauma. The differential diagnosis includes: bizarre periosteal osteochondromatous proliferations of the hands and feet, mature lesions of myositis ossificans, osteogenic sarcoma, confluent lesions of extra-articular synovial chondromatosis, and nodular forms of florid periostitis. True heterotopic bone formation is a benign condition, which of itself requires no specific treatment.

Adult↗

PubMed1987

Heterotopic ossification and pseudoarthrosis in the shoulder following encephalitis. A case report and review of the literature.

Heterotopic bone formation, or myositis ossificans, is common, particularly following trauma, total hip arthroplasty, spinal cord injury, severe head injury, and long-term coma. Although the mechanism is unknown, the pathogenesis is assumed to depend on transformation of mesenchymal cells to bone forming cells in response to a variety of stimuli. The clinical findings, laboratory data, roentgenograms, and radionuclide studies are standard aids in the diagnosis of heterotopic ossification. The treatment usually consists of range-of-motion exercise, nonsteroidal antiinflammatory drugs, X-ray therapy, disodium etidronate (EHDP), and excisional surgery. Reported here is a rare case of periarticular heterotopic ossification in the shoulder of a 38-year-old woman following head injury and 13 months in a coma. The unusual feature was the development of a pseudoarthrosis within the heterotopic bone. The patient's shoulder became markedly stiff with the development of a heterotopic pseudoarthrosis. Excision of the heterotopic bone and pseudoarthrosis was performed to improve the range of motion. Clinical roentgenographic, radionuclide, and pathologic observations are presented on the formation of a synovial joint within the heterotopic bone.

Adult↗

PubMed1987

[Post-traumatic and symptomatic lumbar intertransverse process bone bridge. Apropos of a case: review of the literature].

Osseous bridging of lumbar transverse processes is very seldom seen. A review of the literature has revealed only thirty-six reports. The first cases were thought to be of congenital origin. Subsequently however, the post-traumatic nature of osseous bridging was proved in ten cases. It is obviously a peculiar localization of myositis ossificans. We report a new case, with proof of the post-traumatic nature, associated with symptoms of sciatica.

Adult↗

PubMed1987

Results of total hip arthroplasty without trochanteric osteotomy following hip fusion.

Other than the results of the Charnley group, using a transtrochanteric approach, there is little in the literature regarding the techniques and results of total hip arthroplasty following hip fusion. Thirteen cases carried out via an anterior Smith-Peterson approach have been performed by the senior author over the last few years. These cases have been studied to determine pitfalls and outcomes using this method. At one year, seventy-five percent of the cases became Trendelenberg negative. The average range of flexion at one year was 88 degrees and the Harris Hip Score was 2 poor, 2 fair, and 9 good or excellent. Retrospectively, one patient would rather not have had surgery. Nerve and vessel damage was not a problem and neither was myositis ossificans. Where possible, existing hardware was removed six months prior to arthroplasty. However, three femoral shaft splits occurred where noncemented femoral components were used. While it is a technically demanding exercise, the results of total hip replacement following hip fusion are acceptable.

Adult↗

PubMed1986

Fine-needle aspiration of primary soft-tissue lesions.

This study presents the cytologic findings of fine-needle aspiration (FNA) in a series of 136 primary soft-tissue tumors. The cytologic appearances of some rare mesenchymal lesions are presented, including the first (to our knowledge) published descriptions of fibrous hamartoma of infancy and myositis ossificans. Fine-needle aspiration showed high diagnostic sensitivity (95%) and specificity (95%) for the determination of malignancy, approaching that obtained with frozen-section interpretation. Problems encountered with the diagnosis of mesenchymal lesions, including nodular fasciitis, Kaposi's sarcoma, and spindle cell lipoma, are discussed. Based on these findings, recommendations for aspiration cytology of soft-tissue tumors are presented.

Adolescent↗