A case of extensive symptomatic lower limb heterotopic ossification in a boy
Heterotopic ossification refers to the abnormal growth of bone in the soft tissue. This report highlighted the case of heterotopic ossification in early childhood. A 3-year-old boy was presented with poor lower limb mobility and rigid left leg. At the age of 10 days, he developed a small lump as large as a quail egg in his left groin. Within 3 months, the lump grew bigger and spread to his leg and feet. His parents claimed no trauma history. It was confirmed by computed tomography scan which revealed multiple ossifications of the soft tissue infiltrating the lower limb muscles and infiltrating the skin, the pathological features showed hard mature trabeculated bone, mature fatty tissue, and loose connective tissue. The patient was treated with a series of soft tissue resections and was still under the care of surgeon with good prognosis.
Schuetz P, Mueller B, Christ-Crain M, Dick W, Haas H. Amino-bisphosphonates in heterotopic ossification: first experience in five consecutive cases. Spinal Cord. 2005;43(10):604-10. https://doi.org/10.1038/sj.sc.3101761
Pape HC, Marsh S, Morley JR, Krettek C, Giannoudis PV. Current concepts in the development of heterotopic ossification. J Bone Joint Surg Br. 2004;86(6):783-7. https://doi.org/10.1302/0301-620X.86B6.15356
Koch BM, Wu CM, Randolph J, Eng GD. Heterotopic ossification in children with burns: two cases reports. Arch Phys Med Rehabil. 1992;73(11):1104-6.
Khoo SS, Felix LY, Azura L, Manmohan S, Jeffry A. A rare case of heterotopic ossification in a newborn: a case report. Malays Orthop J. 2012;6(3):48-50. https://doi.org/10.5704/MOJ.1207.006
Patil SG, Siddiqua A, Joshi UK, Deshmukh PK, Patil BS, Mangalgi A. Heterotopic ossification: an unusual presentation. Case Report Dent. 2012;2012:516717. https://doi.org/10.1155/2012/516717
Hsu JE, Keenan MA. Current review of heterotopic ossification. UPOJ. 2010;20:126-30.
Teasel RW, Mehta S, Aubut Jl, Ashe M, Tu L. Heterotopic ossification following spinal cord injury. In: Eng JJ, Teasell RW, Miller WC, Wolfe DL, Townson AF, Hsieh JTC, et al., editors. Spinal cord injury rehabilitation evidence. Version 3.0. Vancouver: SCIRE Project; 2010. p. 1-13.
Barlaan PI, Ip WY. Heterotopic ossification in the middle finger: a case report. Case Rep Orthop. 2011;323795. https://doi.org/10.1155/2011/323795
Banovac K, Williams JM, Patrick LD, Levi A. Prevention of heterotopic ossification after spinal cord injury with COX-2 selective inhibitor (rofecoxib). Spinal Cord. 2004;42(12):707-10. https://doi.org/10.1038/sj.sc.3101628
Banovac K, Williams JM, Patrick LD, Haniff YM. Prevention of heterotopic ossification after spinal cord injury with indomethacin. Spinal Cord. 2001;39(7):370-4. https://doi.org/10.1038/sj.sc.3101166
Predescu V, Olaru R, Prescura C, Deleanu B. Rare and disabling heterotopic ossification: a case report. Arch Med. 2015;7(4):1.
de l'Escalopier N, Salga M, Gatin L, GenÃªt F, Denormandie P. Resection of heterotopic ossification around the hip after trauma. EFORT Open Rev. 2019;4(6):263-8. https://doi.org/10.1302/2058-5241.4.180098
Sorriaux G, Denormandie P, Martin JN, Kiefer C, Judet T. Excision of heterotopic new bone around the elbow in patients with head injury: 51 cases. Rev Chir Orthop Reparatrice Appar Mot. 2005;91(5):415-22. French. https://doi.org/10.1016/S0035-1040(05)84358-2
Page P. Current concepts in muscle stretching for exercise and rehabilitation. Int J Sports Phys Ther. 2012;7(1):109-19.
Knight LA, Thornton HA, Turner-Stokes L. Management of neurogenic heterotopic ossification: three case histories to illustrate the role of physiotherapy. Physiotherapy. 2003;89(8):471-7. https://doi.org/10.1016/S0031-9406(05)60004-1
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