Pek CH, Lim MC, Yong R, Wong HP
Correspondence: Dr Chong Han Pek, chonghan.pek@mohh.com.sg
ABSTRACT
Heterotopic ossification (HO) is the aberrant formation of ectopic bone within the soft tissues, of which the aetiology is usually either traumatic or neurogenic. Neurogenic HO is a known but uncommon complication that occurs after a cerebral or spinal insult. The condition may present with a spectrum of symptoms and is often difficult to diagnose clinically. Although different imaging modalities have been used to diagnose HO, clinicians and radiologists may occasionally encounter radiological features of HO that may mimic other disease conditions. We herein report a rare case of neurogenic HO occurring in the non-paretic limb of a patient, and the diagnostic and radiological challenges encountered.
Keywords: ankylosis, heterotopic ossification, hip, neurogenic
Singapore Med J 2014; 55(8): e119-e122; http://dx.doi.org/10.11622/smedj.2014107
REFERENCES
1. Genêt F, Jourdan C, Schnitzler A, et al. Troublesome heterotopic ossification after central nervous system damage: a survey of 570 surgeries. PLoS One 2011; 6:e16632. http://dx.doi.org/10.1371/journal.pone.0016632 | ||||
2. Devnani AS. Management of heterotopic ossification affecting both hips and knees. Singapore Med J 2008; 49:501-4. PMid:18581026 | ||||
3. Garland DE. A clinical perspective on common forms of acquired heterotopic ossification. Clin Orthop Relat Res 1991; 263:13-29. PMid:1899635 | ||||
4. Brooker AF, Bowerman JW, Robinson RA, Riley LH Jr. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am 1973; 55:1629-32. PMid:4217797 | ||||
5. Crawford CM, Varghese G, Mani MM, Neff JR. Heterotopic ossification: are range of motion exercises contraindicated? J Burn Care Rehabil 1986; 7:323-7. http://dx.doi.org/10.1097/00004630-198607000-00005 | ||||
6. Kocaa?a Z, Bal S, Gurgan A. Hemiplegia and heterotopic ossification on the non-paretic extremity: a case report. J Rehabil Med 2007; 39:500-2. http://dx.doi.org/10.2340/16501977-0086 | ||||
7. Kransdorf MJ, Meis JM. From the archives of the AFIP. Extraskeletal osseous and cartilaginous tumors of the extremities. Radiographics 1993; 13:853-84. http://dx.doi.org/10.1148/radiographics.13.4.8356273 | ||||
8. Mavrogenis AF, Guerra G, Staals EL, Bianchi G, Ruggieri P. A classification method for neurogenic heterotopic ossification of the hip. J Orthop Traumatol 2012; 13:69-78. http://dx.doi.org/10.1007/s10195-012-0193-z | ||||
9. Bressler EL, Marn CS, Gore RM, Hendrix RW. Evaluation of ectopic bone by CT. AJR Am J Roentgenol 1987; 148:931-5. http://dx.doi.org/10.2214/ajr.148.5.931 | ||||
10. Amendola MA, Glazer GM, Agha FP, et al. Myositis ossificans circumscripta: computed tomographic diagnosis. Radiology 1983; 149:775-9. http://dx.doi.org/10.1148/radiology.149.3.6647854 | ||||
11. Ledermann HP, Schweitzer ME, Morrison WB. Pelvic heterotopic ossification: MR imaging characteristics. Radiology 2002; 222:189-95. http://dx.doi.org/10.1148/radiol.2221010552 | ||||
12 Kransdorf MJ, Meis JM, Jelinek JS. Myositis ossificans: MR appearance with radiologic-pathologic correlation. AJR Am J Roentgenol 1991; 157:1243-8. http://dx.doi.org/10.2214/ajr.157.6.1950874 | ||||
13. Shehab D, Elgazzar AH, Collier BD. Heterotopic ossification. J Nucl Med 2002; 43:346-53. PMid:11884494 | ||||
14. Mavrogenis AF, Soucacos PN, Papagelopoulos PJ. Heterotopic ossification revisited. Orthopedics 2011; 34:177. PMid:21410128 | ||||
15. Javery O, Jagannathan JP, Saboo SS, et al. Case report: atypical lipomatous tumor with unusual extensive metaplastic ossification. Cancer Imaging 2012; 12:25-30. http://dx.doi.org/10.1102/1470-7330.2012.0004 |