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PubMed1991

Macrophages in trauma-induced myositis ossificans.

The basic cellular mechanisms of different forms of myositis ossificans are poorly known. In the current experiment the nature of the early (24-168 h) inflammatory cell reaction preceding trauma-induced myositis ossificans was studied. New bone formation was induced in the vastus intermedius region of the rabbit quadriceps muscle by means of immobilization and daily passive mobilization. Before the start of treatment, a cell harvesting device (viscose cellulose sponge in a silastic tube) was implanted in the region of interest. The opposite intermedius muscle and a standardized surgical skin wound served as the control sites. The results showed a significantly prolonged invasion of macrophages into the ossifying intermedius muscle as compared with the control intermedius muscle. It is hypothesized that microinjury and subsequent muscle necrosis cause the invasion of macrophages, and these cells respond to the conditions of the traumatized muscle under passive mobilization by releasing osteogenic growth factors.

Animals↗
PubMed1992

Myositis ossificans with atypical clinical, radiographic, or pathologic findings: a review of 23 cases.

Myositis ossificans is a relatively rare, well-defined entity. The 23 cases sent for consultation to two of us (L.V.A. and A.N.) were reviewed. Clinical, radiologic, and microscopic information was reexamined, and special attention was given to features infrequently seen in typical myositis ossificans. Average age at presentation was 23 years, but 1 patient was younger than 2 years, and 2 were younger than 10 years. Due to the uncommon location of 15 lesions and an unusual presentation in 5, the correct diagnosis was not obvious in these cases. A history of trauma was elicited in 8 patients, denied by 7, and was not queried in the remainder. Radiologic studies raised the possibility of a malignant bone-forming tumor in at least three instances; myositis ossificans was originally diagnosed in 6 cases radiologically. In 8 cases, histologic evidence suggested malignancy, including osteosarcoma, either parosteal or extraosseous, in 6. Other diagnoses included epithelioid sarcoma and callus formation. Presentation of these variations from the norm highlights the importance of recognizing the evolution of a nonneoplastic fibro-osseous and cartilaginous entity in which conservative treatment is curative.

Adolescent↗
PubMed1998

Myositis ossificans in the tip of the thumb: a case report.

A case of a myositis ossificans occurring in the distal portion of the finger is reported. An 18-year-old female noticed a small nodule in the tip of the left thumb for 11 months. Plain radiographs showed calcified shadow and there was a radiolucent zone between the mass and the distal phalanx. The excised mass was diagnosed as myositis ossificans. To our best knowledge, there has been no report of a myositis ossificans in the tip of the finger in literature.

Adolescent↗
PubMed1992

Characterization of bone forming cells in posttraumatic myositis ossificans by lectins.

Lectins were used to characterize bone forming cells in posttraumatic myositis ossificans. The lectins applied were as follows: Arachis hypogaea (PNA): specific for beta-D-galactose (1,3)N-acetyl-D-galactosamine (Gal-1,3 GalNac), Canavalia ensiformis (Con A): specific for alpha-D-glucose (D-Glc) and alpha-D-mannose (D-Man) and Wheat germ (WGA): specific for N-acetyl(1,4)D-glucosamine (Glc-NaC) and neuraminic acid. The development of myositis ossificans was characterized by the appearance of a WGA binding cell population. The lectin-binding sites appeared as a cluster in the supranuclear cytoplasm, corresponding to the Golgi-complex. However, the WGA lectin-binding sites disappeared in the mature form of myositis ossificans. We assume that these lectin binding cells may be the bone marrow derived precursors of myofibroblast-like cells which are responsible for bone formation within the damaged muscle.

Adolescent↗
PubMed1999

Cervical myositis ossificans traumatica: a rare location.

An unusual case of myositis ossificans traumatica lesion located in the paraspinal region is reported. Despite the contiguity of the lesion with the cervical vertebrae and ominous appearance of the biopsy material, the history of antecedent trauma and computed tomography findings allowed preoperative accurate diagnosis. To our knowledge, myositis ossificans traumatica located in the cervical paraspinal region is very rare.

Adult↗
PubMed1993

[Osteogenetic cells in myositis ossificans].

We have used the lectins Arachis hypogaea (PNA), Canavalia ensiformis (Con A) and Triticum vulgaris (WGA) for the examination of bone forming cells in 8 variously differentiated cases of myositis ossificans. The development of myositis ossificans could be characterized with the appearance of a WGA binding cell population. In this cell population the lectin binding spots may be found in the perinuclear cytoplasm, possibly in the Golgi complex. The lectin binding of the bone forming cells has disappeared in the ripe myositis ossificans. We think that the WGA binding cell population may be equal with the progenitor cells, wandering in form the stroma ot the bone marrow and that the ability of WGA binding may be a characteristic developmental marker of these cells.

Adult↗
PubMed1986

Myositis ossificans circumscripta: a complication of tetanus.

Myositis ossificans developed in a 67-year-old man recovering from tetanus. This rare complication develops in the convalescent phase of tetanus through metaplastic changes in undifferentiated connective tissue cells in areas of myocellular injury. Anoxia, hematoma formation, and immobilization may be contributing factors. Permanent loss of joint motion may be the end result of this ossifying process.

Aged↗
PubMed1999

Magnetic resonance imaging helps in the early diagnosis of myositis ossificans in children.

Two cases on myositis ossificans circumscripta (MOC) in the arm are reported. Plain X-ray films and magnetic resonance imaging (MRI) were performed in both cases. In the first, an intramuscular tumor-like mass without calcifications was found on MRI with soft-tissue edema extension. In the second, MRI disclosed additional bone-marrow edema. The diagnosis of MOC was confirmed by biopsy in one case and by follow-up in the other. MOC is a benign soft-tissue lesion that is rare in children, with an acute course and usually spontaneously favorable evolution. The differential diagnosis from an infection or a malignant tumor remains difficult. The best imaging modalities are conventional radiography and MRI. The MRI patterns of MOC are typical but not pathognomonic; typical MRI findings in conjunction with clinical symptoms during the early phase of MOC permit the postponement of a biopsy or aggressive surgical procedures. Surgery is indicated for cases not showing typical MOC calcifications at a later stage.

Adolescent↗
PubMed1999

Myositis ossificans demonstrated by positive gallium-67 and technetium-99m-HMDP bone imaging but negative technetium-99m-MIBI imaging.

Gallium-67-citrate and 99mTc-diphosphate bone imaging agents are localized in myositis ossificans, a tumor-like benign soft-tissue mass that makes it impossible to differentiate between malignant tumor and the infection/inflammatory process. We present such a myositis ossificans patient whose bone and 67Ga-citrate imagings showed increased uptake in the left thigh and two foci of the right gluteal region leading to inconclusive results. Technetium-99m-MIBI imaging showed the absence of substantial uptake in these regions. ACT scan confirmed myositis ossificans. The lack of 99mTc-MIBI uptake in myositis ossificans means that 99mTc-MIBI imaging may be useful in the differential diagnosis.

Aged↗
PubMed1975

Pseudomalignant myositis ossificans. A pathological study of eight cases.

Eight cases of pseudomalignant myositis ossificans are presented. There was a male predominance and four patients were under 20 years of age. There was no history of trauma, but there was evidence of mild local or general inflammation with positive roentgenograms in two cases. Histologically there was active fibroblastic proliferation, appearing to develop essentially in fibrin deposits with metaplasia leading to the formation of an unusual osteoid. The newly formed mass was surrounded by bone and compressed the surrounding muscle fibers, which were either atrophic or trapped therein. The histological criteria distinguishing this disorder from other forms of myositis ossificans are discussed, and comparisons are drawn with nodular fascitis and proliferative myositis. An association with the latter was observed in one case. This nontumourous growth must be distinguished from osteogenic sarcoma of soft tissue. The differential diagnosis is based on careful histological criteria, which must be supported by clinical and radiological data.

Adolescent↗
PubMed2006

Myositis ossificans of the abdominal rectus muscle: report of a case.

We herein report a rare case of myositis ossificans originating from the abdominal rectus muscle, found in a 38-year-old woman who presented with a left upper abdominal mass. The mass was initially suspected to be a malignant neoplasm because no history of either operation or trauma existed for this patient. Moreover, the location of the mass was unusual and the enhancement patterns of the dynamic magnetic resonance images were similar to that of a malignant tumor. Based on the radiologic findings, a surgical exploration was performed. A well-circumscribed mass, which measured 3.2 x 2 cm, was found in the rectus muscle. Microscopic findings showed a typical zonal pattern with a fibroblastic central zone and a zone of ossification at the periphery. Although abdominal myositis ossificans is extremely rare, it is one of the causes of abdominal mass lesions and can be mistaken for a malignant tumor. Therefore, a thorough knowledge of the evolution of myositis ossificans is necessary and in cases with malignant suggestion on magnetic resonance imaging, like that seen in our case, we suggest that a surgical excision may be necessary for both the diagnosis and treatment.

Abdominal Neoplasms↗
PubMed1987

Gallium uptake in myositis ossificans. Potential pitfalls in diagnosis.

Seven cases of gallium uptake in myositis ossificans are described. Gallium scans are done frequently in paraplegics, quadriplegics, and comatose patients to look for occult infection. It is important to be aware of possible gallium uptake in myositis ossificans, particularly in the extremities, which is frequent in these patients. Gallium uptake may be present prior to any abnormalities seen on plain films or CT scans. It is important to correlate roentgenograms with abnormal gallium scans, particularly in the extremities, to avoid potential pitfalls in diagnosis and prevent unnecessary antibiotic treatment. A bone scan should be obtained whenever possible, particularly when roentgenograms are negative, to confirm the diagnosis.

Adult↗
PubMed2004

MR imaging findings of an unusual case of myositis ossificans presenting as a progressive mass with features of fluid-fluid level.

We present a case of myositis ossificans involving the upper arm in which features of fluid-fluid level became apparent on magnetic resonance imaging (MRI). Serial MR images obtained over a 6-month period exhibited progressive appearances in the absence of dense mineralization in the early and mid phases, which simulate neoplastic conditions. Twenty-four weeks following the biopsy, MR images revealed that the mass had decreased in size with the disappearance of most of the features of fluid-fluid level. To the best of our knowledge, no example of myositis ossificans accompanied by features of fluid-fluid level, which was closely monitored by MRI, exists in the literature. These features of image examination should be evaluated cautiously to avoid unnecessary surgical intervention, especially in instances where lesions exhibit expansive appearance. This case provided beneficial information regarding the sequence of changes in terms of MR appearance of myositis ossificans.

Adult↗
PubMed2005

Myositis ossificans of the temporal muscle as a primary scalp tumor. Case report.

A 38-year-old woman presented with a rare case of myositis ossificans in the temporal muscle manifesting as left temporal scalp mass with mild pain. The mass was elastic-hard and seemed to be located in the temporal muscle. Magnetic resonance imaging revealed a heterogeneously enhanced mass in the muscle. The tumor was resected. The histological diagnosis was myositis ossificans. The clinicopathological features of scalp myositis ossificans may mimic other soft tissue tumors, requiring care for the differential diagnosis.

Adult↗
PubMed1987

Myositis ossificans after total hip replacement and perioperative muscle ischemia.

It has been suggested that muscle ischemia could contribute to myositis ossificans and that the ischemia could result from prolonged retraction during surgery. Biopsy specimens of the gluteus medius muscle were taken at the beginning and the end of 30 primary total hip arthroplasties and the intracellular lactate and phosphocreatine (PCr) measured. Postoperative myositis ossificans was classified according to Brooker after 1 year, and the surface of the heterotopic bone projected above the greater trochanter in an anteroposterior roentgenogram was measured by planimetry. The findings suggest that muscle ischemia is not an important cause of myositis ossificans after hip arthroplasty, but elevated levels of lactate and lowered levels of intracellular PCr may occur as nonspecific responses to tissue trauma that through other mechanisms may lead to ossification.

Aged↗
PubMed2006

[Myositis ossificans of the neck in a 47 year old patient].

BACKGROUND: Myositis ossificans is a heterotopic ossification of the soft tissue, which leads in progredient cases to functional disorder. Cervical localization is a rare entity. The clinical symptoms are more or less unspecific. Indicating is a foregoing trauma of the affected region. CASE REPORT: We report about a 47 year old male patient with a dorsocervical mass, which had caused dysfunction. He was operated after the diagnosis had been histologically and radiologically confirmed. CONCLUSIONS: In case of cervical tumors with radiological evidence of partial calcification differential diagnosis should keep in mind myositis ossificans next to tuberculosis or sarcoma. Surgery and postoperative prophylaxis with Indometacin is the therapy of choice.

Biopsy↗