1/12. Fibrodysplasia ossificans progressiva and associated osteochondroma of the coronoid process in a child.The article reports the occurrence of osteochondroma in a fibrodysplasia ossificans progressiva patient. A 5-year-old boy presented with limited mouth opening and firm swelling of the right zygomatic complex area. The boy had bilateral hallux valgus of the great toes and heterotopic endochondral ossification of facial and neck regions. Associated osteochondroma of the coronoid process and aggressive heterotopic ossification of masticatory and neck muscles were found in response to traumatic injuries. Natural and clinical histories of fibrodysplasia ossificans progressiva were reviewed. An early diagnosis and avoidance of factors that aggravate ossification are key factors in reducing the expected degree of physical disabilities of patients. An early recognition of congenital skeletal deformities, early detection of abnormal ossification, and awareness of the disease by the involved physicians are important factors in the early diagnosis of the disease and in reducing any unnecessary trauma. Bone scintigrams and CT scans are effective noninvasive tools for an early detection of ossification and for monitoring the progression of the disease. Further investigation of its pathogenesis at a molecular level is important to understand better the nature of the disease and to develop an effective treatment protocol.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/12. myositis ossificans after a supracondylar fracture of the humerus in a child.myositis ossificans After a Supracondylar Fracture of the humerus in a child. In addition to the better known complications of supracondylar humerus fractures, myositis ossificans is often listed as a less common complication. This complication is extremely rare in children and historically has been attributed to high-energy trauma, manipulation, surgical intervention, aggressive passive range-of-motion exercises, or associated head injury. We present a case report of a 3-year-old girl who developed myositis ossificans after a low-energy supracondylar fracture of the humerus despite having been treated without manipulation, surgery, or physical therapy. This report illustrates that supracondylar humerus fractures can be complicated by myositis ossificans despite the best attempts at prevention.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/12. Pseudomalignant myositis ossificans of the wrist causing compression of the ulnar nerve and artery. A case report.myositis ossificans (MO) is a condition characterised by focal, benign and self-limited idiopathic heterotopic bone formation. It is extremely rare in the hand and wrist and may lead to concomitant nerve compression. Because of the rare incidence of pseudomalignant MO at the wrist and hand, we found it of interest to report a case of this condition localised to the wrist. A 31-year-old female patient presented with swelling and pain of her left wrist. The physical examination findings, magnetic resonance imaging and Tc-99m bone scan suggested acute osteomyelitis or a tumoral condition. Incisional biopsy and pathological examination was done. The microscopic findings confirmed that the lesion was pseudomalignant MO. The lesion was removed totally and decompression of the ulnar nerve and artery was achieved. The patient regained full asymptomatic range of motion of all digits and wrist and the numbness of the fourth and fifth digits had subsided at follow-up five months later.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/12. The spine in fibrodysplasia ossificans progressiva: a case report.STUDY DESIGN: A case report of fibrodysplasia ossificans progressiva (FOP). OBJECTIVES: To report a very rare cause of back pain. SUMMARY OF BACKGROUND DATA: FOP is an autosomal dominant disorder with overexpression of bone morphogenetic protein 4 and negative HLA B27. Pathognomonic are congenital malformations of the big toes. methods: The authors report on a patient with FOP who presented with back pain at their outpatient clinic. RESULTS: On physical examination, several indurated masses were visible and palpable close to the left and right scapula and the thoracic spine. These were not tender or painful, nor warmed or inflamed. A significantly decreased range of motion of all levels of the spine and the shoulder were found. On the radiographs, segmentation defects of the cervical and lumbar spine as well as synostoses of the spinal processes were seen. The cervical vertebral bodies were small and unusually high. Heterotopic ossifications could be discerned in the lumbar postural muscles and the facet joints of the spine were ankylosed. Additionally to these findings, on the thoracic radiographs ossifications of the muscles of the shoulder girdle could be seen. The pathognomonic shortening of the first metatarsal bone and the proximal phalanx was bilaterally present. The surface shaded 3D-reconstruction of the computed tomography of the trunk showed multiple bulky and confluating ossifications of the shoulder girdle. The spinal processes of the thoracic spine were anklyosed by massive ossifications of the postural muscles. CONCLUSIONS: In FOP, diagnosis can be made by the typical clinical and radiological features.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/12. myositis ossificans circumscripta of the knee improved by alendronate.myositis ossificans circumscripta (MOC) is a rare benign disorder characterized by heterotopic ossification of soft tissues. We report a case in a 21-year-old male who presented with knee pain after strenuous physical activity. Evidence of inflammation of the knee and a hard swelling in the subquadricipital area were the main physical findings. The initial plain radiographs showed a subpatellar soft tissue mass containing flocculent calcifications. Over the next 2 months, the calcific deposits organized into a calcified mass. magnetic resonance imaging findings were nonspecific, with a mass within the vastus medialis muscle generating low signal on T1 images and high signal on T2 images, without postgadolinium enhancement. Computed tomography showed several calcific deposits arranged in a ring, strongly suggesting MOC. Histological examination of a biopsy specimen confirmed this diagnosis. alendronate therapy given for 6 months was followed by marked clinical improvement, obviating the need for surgery.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
6/12. Post-traumatic severe trismus caused by impairment of the masticatory muscle.Restriction of the mouth opening from a pathologic condition outside the temporomandibular joint is called a pseudo- or extra-articular ankylosis. The authors report two cases of severe post-traumatic pseudoankylosis. One case showed fibrous degeneration of the bilateral masseter muscles without a facial bone fracture, which caused severe trismus, a mouth opening of less than 2 mm, and gradually appeared after blunt injuries to the face. The other was a rare case accompanied with the bone formation in the masseter muscle and was diagnosed as myositis ossificans traumatica, which also presented as severe trismus, with a maximal mouth opening of 5 mm after facial violence. Both were surgically treated with dissection of the affected muscles. In addition, a hemicoronoidotomy was performed in the case of myositis ossificans traumatica. Although a conservative therapy with physical rehabilitation is the basic policy for the management of pseudoankylosis of the temporomandibular joint, a surgical treatment should be considered when the origin of the problems is an osteogenic character or severe extra-articular ankylosis resistant to conservative therapy before completion of true temporomandibular joint ankylosis.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/12. Bilateral and recurrent myositis ossificans in an athlete: a case report and review of treatment options.An unusual case of recurrent myositis ossificans (MO) bilaterally in the hamstring muscles of a 47-year-old athlete secondary to trauma is presented with a review of the literature of current treatment options. MO is a common condition that occurs among athletes in association with muscle and/or tendon strain or contusion. After an extensive literature review, we believe this to be the first case reported of recurrent and bilateral MO in a nonsurgical setting from recurrent hamstring strains. Plain radiographs and physical examination revealed the appearance and chronology of this pathology. Treatment options to improve flexibility and decrease morbidity are discussed along with prophylaxis for future injury. Treatment of mobility and flexibility, rehabilitation goals and treatment with nonsteroidal anti-inflammatory drugs, bisphosphonates, and magnesium are discussed along with prophylaxis.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/12. Pseudomalignant heterotopic ossification ("myositis ossificans"). recurrence after excision with subsequent resorption.An eight-year-old boy presented with massive pseudomalignant heterotopic ossification around the upper femur. The mass was completely excised because of severe pain, systemic illness and a flexion contracture at the hip. Symptomatic improvement was swift, but two weeks later the mass had recurred and was even more extensive. During the subsequent 18 months of conservative management he has been free of pain and there has been progressive resorption and remodelling of the heterotopic bone. There is now no limitation of physical activity and movement at the hip is full.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/12. 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.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/12. Fibrodysplasia ossificans progressiva in south africa. case reports.Six patients with fibrodysplasia ossificans progressiva, a condition not previously reported in Blacks in this country, have been reviewed. All had serious physical disability and medical or surgical therapy did not influence the course of the disease. By extrapolation from prevalence data established in Britain, it can be estimated that there are at least 10 additional affected individuals in southern Africa.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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