Heterotopic Ossification: Difference between revisions
No edit summary |
No edit summary |
||
Line 19: | Line 19: | ||
== Characteristics/Clinical Presentation == | == Characteristics/Clinical Presentation == | ||
Clinical signs and symptoms of HO may appear as soon as 3 weeks or up to 12 weeks after initial musculoskeletal trauma, spinal cord injury, or other precipitating event.<ref name="Shehab et al. ">Shehab D, Elgazzar AH, Collier BD. Heterotopic ossification. Jour of Nuclear Medicine 2002; 43: 346-353.</ref> | Clinical signs and symptoms of HO may appear as soon as 3 weeks or up to 12 weeks after initial musculoskeletal trauma, spinal cord injury, or other precipitating event.<ref name="Shehab et al.">Shehab D, Elgazzar AH, Collier BD. Heterotopic ossification. Jour of Nuclear Medicine 2002; 43: 346-353.</ref> | ||
Findings which may suggest the presence of HO are as follows:<ref name="Pape HC et al. " /> | Findings which may suggest the presence of HO are as follows:<ref name="Pape HC et al." /> | ||
*joint swelling and warmth (initial phase) | *joint swelling and warmth (initial phase) [[Image:Heterotopic.gif|right]] | ||
*joint pain | *joint pain | ||
*palpable mass, firm (late stage) | *palpable mass, firm (late stage) |
Revision as of 21:38, 16 March 2011
Original Editors - Bruce Tan from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Definition/Description[edit | edit source]
Heterotopic Ossification (HO) refers to the formation of lamellar bone inside soft tissue structures where bone does not normally exist. This process can occur in structures such as the skin, subcutaneous tissue, skeletal muscle, and fibrous tissue adjacent to bone. In more rare forms, HO has also been described in the walls of blood vessels and intra-abdominal sites such as the mesentery.[1]
Research suggests four factors which contribute to formation of heterotopic bone: 1) inciting event (usually trauma), 2) a signal from the site of injury, 3) a supply of mesenchymal cells whose genetic machinery is not fully committed, 4) an environment which is conducive to the continued formation of new bone.[1] These factors are discussed more indepth in the Etiology/Causes section.
HO was fisrt described by by Patin in 1692 while working with children diagnosed with myositis ossificans progressiva.[2] It was not until 1918 when Dejerine & Ceillier detailed the anatomical, clinical, and histological features of ectopic bone formation in soldiers who sustained spinal injuries during World War I.[3]
Prevalence[edit | edit source]
add text here
Characteristics/Clinical Presentation[edit | edit source]
Clinical signs and symptoms of HO may appear as soon as 3 weeks or up to 12 weeks after initial musculoskeletal trauma, spinal cord injury, or other precipitating event.[4]
Findings which may suggest the presence of HO are as follows:[3]
- joint swelling and warmth (initial phase)
- joint pain
- palpable mass, firm (late stage)
- decreased ROM of effected joint
Associated Co-morbidities[edit | edit source]
add text here
Medications[edit | edit source]
add text here
Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
Etiology/Causes[3][edit | edit source]
Systemic Involvement[edit | edit source]
add text here
Medical Management (current best evidence)[edit | edit source]
add text here
Physical Therapy Management (current best evidence)[edit | edit source]
add text here
Alternative/Holistic Management (current best evidence)[edit | edit source]
add text here
Differential Diagnosis[edit | edit source]
add text here
Case Reports/ Case Studies[edit | edit source]
- Kennedy MA, Sama AE, Sigman M. Tibiofibular syndesmosis and ossification. case report: sequelae of ankle sprain in an adolescent football player. Journ of Emer Med 2000; 18: 233-240.
- Bovo G, Romano F, Perego E, Franciosi C et al. Heterotopic mesenteric ossification ("intraabdominal myositis ossificans"): a case report. International Journal of Surgical Pathology 2004; 12: 407-409.
- Brower RS, Vickroy NM. A case of psoas ossification from the use of BMP-2
for posterolateral fusion at L4–L5.Spine 2008; 18: 653-655.
Resources
[edit | edit source]
add appropriate resources here
Recent Related Research (from Pubmed)[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 McCarthy EF, Sundaram M. Heterotopic ossification: a review. Skeletal Radiol 2005; 34: 609-619.
- ↑ Bossche LV, Vanderstraeten G. Heterotopic ossification: a review. J Rehabil Med 2005; 37: 129-136.
- ↑ 3.0 3.1 3.2 Pape HC et al. Current concepts in the development of hetetrotopic ossification. Journ Bone and Joint Surg 2004; 86: 783-787.
- ↑ Shehab D, Elgazzar AH, Collier BD. Heterotopic ossification. Jour of Nuclear Medicine 2002; 43: 346-353.