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Bai Q, Zou X, Yang G, Fan Y, Wang W, Zhang B, Chang X. Painful and restricted hip due to myositis ossificans circumscripta of the pectineus muscle after pelvic fracture: A case report. Medicine (Baltimore) 2023; 102:e33694. [PMID: 37115044 PMCID: PMC10145730 DOI: 10.1097/md.0000000000033694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
RATIONALE Myositis ossificans circumscripta (MOC) is a rare disorder that causes heterotopic bone formation in soft tissues. It usually occurs after trauma and affects large muscles of the extremities. MOC of the pectineus muscle is extremely rare and has not been reported to be treated surgically. PATIENT CONCERNS A 52-year-old woman presented with left hip pain and dysfunction 4 months after a traffic accident that caused pelvic and humeral fractures and cerebral hemorrhage. DIAGNOSES Radiological imaging revealed isolated ossification of the left pectineus muscle. The patient was diagnosed with MOC. INTERVENTIONS The patient underwent surgical resection of the ossified pectineus muscle followed by local radiation and medical therapy. OUTCOMES At 12 months postoperatively, she was asymptomatic and had normal hip function. No recurrence was observed on radiography. LESSONS MOC of the pectineus muscle is a rare condition that can cause severe hip dysfunction. Surgical resection combined with radiation and anti-inflammatory drugs can be an effective treatment option for patients who do not respond to conservative management.
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Affiliation(s)
- Qiushi Bai
- Department of Orthopaedics, Peking Union Medical College Hospital, Beijing, China
| | - Xiongfei Zou
- Department of Orthopaedics, Peking Union Medical College Hospital, Beijing, China
| | - Gang Yang
- Department of Orthopaedics, Peking Union Medical College Hospital, Beijing, China
| | - Yu Fan
- Department of Orthopaedics, Peking Union Medical College Hospital, Beijing, China
| | - Wenze Wang
- Department of Pathology, Peking Union Medical College Hospital, Beijing, China
| | - Baozhong Zhang
- Department of Orthopaedics, Peking Union Medical College Hospital, Beijing, China
| | - Xiao Chang
- Department of Orthopaedics, Peking Union Medical College Hospital, Beijing, China
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Huenerfauth EI, Molnár V, Rosati M, Ciurkiewicz M, Söbbeler FJ, Harms O, Hildebrandt R, Baumgärtner W, Tipold A, Volk HA, Nessler J. Case Report: Unable to Jump Like a Kangaroo Due to Myositis Ossificans Circumscripta. Front Vet Sci 2022; 9:886495. [PMID: 35865877 PMCID: PMC9295721 DOI: 10.3389/fvets.2022.886495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
A male 10-year-old captive red kangaroo (Macropus rufus) was presented with a chronic progressive pelvic limb lameness and reluctance to jump. The general examination revealed a palpable induration of the lumbar epaxial muscles. Magnetic resonance imaging performed under general anesthesia revealed bilateral almost symmetric, well-circumscribed mass lesions in superficial erector spinae muscles. The lesions had irregular to multilobulated appearance with hyper-, hypo-, and isointense areas in T2- and T1-weighted (w) sequences without contrast enhancement. On computed tomography, a peripheral rim of mineralization was apparent. Histopathological analysis of a muscle biopsy showed osseous trabeculae with rare clusters of chondrocytes indicating metaplasia of muscle tissue to bone. No indications of inflammation or malignancy were visible. The clinical, histopathological, and imaging workup of this case was consistent with myositis ossificans circumscripta. This disorder is particularly well-known among human professional athletes such as basketball players, where excessive, chronic-repetitive force or blunt trauma causes microtrauma to the musculature. Metaplasia of muscle tissue due to abnormal regeneration processes causes heterotopic ossification. The kangaroo's clinical signs improved with cyto-reductive surgery, cage rest, weight reduction, and meloxicam without further relapse.
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Affiliation(s)
- Enrice I. Huenerfauth
- Department of Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Foundation, Hannover, Germany
- *Correspondence: Enrice I. Huenerfauth
| | | | - Marco Rosati
- Section of Clinical and Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität, Munich, Germany
| | - Malgorzata Ciurkiewicz
- Department for Pathology, University of Veterinary Medicine Foundation, Hannover, Germany
| | - Franz J. Söbbeler
- Department of Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Foundation, Hannover, Germany
| | - Oliver Harms
- Department of Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Foundation, Hannover, Germany
| | - Robert Hildebrandt
- Department of Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Foundation, Hannover, Germany
| | - Wolfgang Baumgärtner
- Department for Pathology, University of Veterinary Medicine Foundation, Hannover, Germany
| | - Andrea Tipold
- Department of Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Foundation, Hannover, Germany
| | - Holger A. Volk
- Department of Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Foundation, Hannover, Germany
| | - Jasmin Nessler
- Department of Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Foundation, Hannover, Germany
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Isse HM, Sereke SG, Vincent M, Zeridah M. Non‐traumatic myositis ossificans circumscripta in the anterior abdominal wall of a seven‐year‐old Ugandan child: A case report. Clin Case Rep 2022; 10:e6145. [PMID: 35898744 PMCID: PMC9309742 DOI: 10.1002/ccr3.6145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/04/2022] [Accepted: 06/11/2022] [Indexed: 11/14/2022] Open
Abstract
Myositis ossificans circumscripta (MOC) is a benign and self‐limiting heterotopic ossification in the subcutaneous fat, tendons, muscles, and nerves. It is commonly due to trauma and is frequently encountered in the arm, shoulder, thigh, and hand which are prone to trauma. Non‐traumatic MOC arising from the abdominal muscles is extremely rare. We report a case of 7‐year‐old male child with a three‐year history of progressive painless abdominal swelling in the left hypochondria region with no history of associated trauma. CT scan of the abdomen showed a well‐defined hyperdense mass in the left external oblique muscle. Histological diagnosis confirmed myositis ossificans of the external oblique muscle. The mass was removed surgically with no immediate or late complications. Non‐traumatic MOC of the abdominal muscles is very rare. Radiological investigations are crucial in the diagnosis and for differentiating a MO lesion from other malignant soft‐tissue tumors as we demonstrated in this case report.
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Affiliation(s)
- Hamdi Mohamed Isse
- Department of Radiology and Radiotherapy, School of Medicine Makerere University College of Health Sciences Kampala Uganda
| | - Senai Goitom Sereke
- Department of Radiology and Radiotherapy, School of Medicine Makerere University College of Health Sciences Kampala Uganda
| | - Mboizi Vincent
- Department of Radiology and Radiotherapy, School of Medicine Makerere University College of Health Sciences Kampala Uganda
| | - Muyinda Zeridah
- Department of Radiology and Radiotherapy, School of Medicine Makerere University College of Health Sciences Kampala Uganda
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Abstract
We report a case of a 29-year-old man who had been a victim of a public road accident. Four weeks later, the patient developed an isolated right thigh mass located ventrally in the distal one-third of the thigh. The mass was painful and associated with fever and inflammatory syndrome. Plain radiographs showed a bilateral calcified thickening of soft tissues with well-defined bony margins. Ultrasound objectified diffuse calcifications of soft tissues.CT scan-confirmed the diagnosis of myositis ossificans circumscripta, showing a bilateral thickening of the vastus intermedius chief of the quadriceps dotted with calcifications, extending along the femur axis. These calcifications have well-defined bony margins separated from the periosteum by a lucent zone.
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Affiliation(s)
- Manel Landolsi
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Tej Mrad
- Department of Radiology, Military Hospital Tunisia, Tunis, Tunisia
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Nishiguchi S, Sekine I, Kuroda S, Sato M, Kitagawa I. Myositis Ossificans of the Hip Due to Pyogenic Arthritis Caused by Campylobacter fetus Subspecies fetus. Intern Med 2017; 56:967-972. [PMID: 28420848 PMCID: PMC5465416 DOI: 10.2169/internalmedicine.56.7906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
A 61-year-old woman was admitted with severe hip pain causing immobility and high serum levels of inflammatory markers. The patient had a medical history of diabetes. She had been scheduled to undergo right hip replacement surgery for the treatment of osteoarthritis associated with gradually progressive pain. On admission, an enhanced abdominal computed tomography scan showed an abnormal increase in synovial fluid surrounding the right ilium, with piriformis muscle calcification. Subsequent blood and specimen cultures identified Campylobacter fetus subspecies fetus. This is a rare report of a case of myositis ossificans followed by C. fetus pyogenic arthritis of the hip.
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Affiliation(s)
- Sho Nishiguchi
- Department of General Internal Medicine, Shonan Kamakura General Hospital, Japan
| | - Ichiro Sekine
- Department of General Internal Medicine, Shonan Kamakura General Hospital, Japan
| | - Shun Kuroda
- Department of General Internal Medicine, Shonan Kamakura General Hospital, Japan
| | - Morihiko Sato
- Department of Infection Control and Prevention, Shonan Kamakura General Hospital, Japan
| | - Izumi Kitagawa
- Department of General Internal Medicine, Shonan Kamakura General Hospital, Japan
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El Bardouni A, Boufettal M, Zouaidia F, Kharmaz M, Berrada MS, Mahassini N, El Yaacoubi M. Non-traumatic myositis ossificans circumscripta: A diagnosis trap. J Clin Orthop Trauma 2014; 5:261-5. [PMID: 25983509 PMCID: PMC4264036 DOI: 10.1016/j.jcot.2014.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 09/19/2014] [Indexed: 11/24/2022] Open
Abstract
Myositis ossificans circumscripta (MOC) is a benign condition of non-neoplastic heterotopic bone formation in the muscle or soft tissue. Trauma plays a role in the development of MOC, thus, non-traumatic MOC is very rare. Although MOC may occur anywhere in the body, the lesions are localized predominantly in the high-risk sites of injury, such as the thigh, buttock, and elbow. MOC can easily be mistaken for osteomyelitis or a malignant tumor, specifically osteosarcoma or soft-tissue sarcoma. We report a rare case of non-traumatic myositis ossificans circumscripta of thigh which appear clinically and radiologically as a malignant neoplasm. Despite its rarity, MOC should be contemplated in the differential diagnosis of malignant tumors.
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Affiliation(s)
- Ahmed El Bardouni
- Department of Orthopedic Surgery, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco
| | - Monsef Boufettal
- Department of Orthopedic Surgery, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco
| | - Fouad Zouaidia
- Department of Pathological Anatomy, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco
| | - Mohamed Kharmaz
- Department of Orthopedic Surgery, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco
| | - Mohamed S. Berrada
- Department of Orthopedic Surgery, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco
| | - Najat Mahassini
- Department of Pathological Anatomy, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco
| | - Moradh El Yaacoubi
- Department of Orthopedic Surgery, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco
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Abstract
Myositis ossificans is a pseudoinflammatory tumour that originates from skeletal muscle and corresponds to a heterotopic, metaplastic, nonmalignant bone tumour. The purpose of this article is to report the case of myositis ossificans circumscripta (MOC) of the psoas muscle due to overuse in an adolescent gymnast. A 16-year-old female athlete presented at our outpatient orthopaedic clinic for evaluation of a 1-month history of low back pain. Initial plain radiographs were initially interpreted as negative, and laboratory values were normal. MRI imaging demonstrated a circumscribed mass with associated oedema in the psoas muscle. Computed tomography-guided percutaneous biopsy was performed and histology confirmed the diagnosis of MOC. Conservative treatment was initiated with rest and anti-inflammatory drugs (indomethacin). The patient had a resolution of pain and function after 3 months of conservative treatment. At 6 months' follow-up, MRI demonstrated complete resolution of the lesion and she gradually returned to her sports activity. At last follow-up she was asymptomatic. MOC is a rare lesion in the paediatric-adolescent population. To our knowledge, this is the first report of MOC in the psoas muscle produced by overuse. MRI is very sensitive in detecting oedema during the acute phase of the lesion. Conservative treatment should be considered, especially at the early stage of the disease. Spontaneous resolution can be expected in most cases.
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Mishra PK, Singhal P, Shukla J, Maravi DS. Osteomyelitis of Myositis Ossificans in Arm - First Case Report. J Orthop Case Rep 2014; 4:57-9. [PMID: 27299005 PMCID: PMC4719274 DOI: 10.13107/jocr.2250-0685.228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction: Myositis ossificans [MO] is a benign heterotropic bone forming (often- self resolving) pathology of bone and soft tissue. Here we are reporting the first time in literature for osteomyelitis of myositis ossificans in arm of a male due to trauma as a perusal of rare entity. Case Report: It is a case report of a 25 years old male presented to us in out-patient department with chief complaint of discharging wounds over mid part of left arm since six months. Clinically provisional diagnosis of chronic osteomylitis of left humerus made and his x-ray sought. X- Ray showed geographic appearance of myositis ossificans around the upper two third of left arm. Sinuses curetted and infected bone (part of myositis ossificans) removed and sent for biopsy. Now the patient is discharge and sinus free, and has resumed his work. Conclusion: Osteomyleitis of myositis ossificans should be recognized as a possible differential diagnosis chronic discharging sinus. This type of presentation of myositis ossificans is rarest.
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Affiliation(s)
- Pankaj Kumar Mishra
- Department of Orthopaedics, Gandhi Medical College and Hamidia Hospital Bhopal M.P. India
| | - Prakhar Singhal
- Department of Orthopaedics, Gandhi Medical College and Hamidia Hospital Bhopal M.P. India
| | - Jiten Shukla
- Department of Orthopaedics, Gandhi Medical College and Hamidia Hospital Bhopal M.P. India
| | - Deepak Singh Maravi
- Department of Orthopaedics, Gandhi Medical College and Hamidia Hospital Bhopal M.P. India
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