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Rationale: Myositis ossificans (MO) is characterized by benign heterotopic ossificans in soft tissues like muscles, which can be classified into nonhereditary MO and fibrodysplasia ossificans progressiva (FOP). Nonhereditary MO is characterized by ossification of the soft tissues after acute or repetitive trauma, burns, or surgical intervention. FOP is a rare and crippling disease characterized by congenital malformation of the big toe and heterotopic ossification in muscle. The majority of FOP's musculoskeletal traits are associated with dysregulated chondrogenesis. The diagnosis is mainly based on clinical manifestation, imaging examination, and genetic analysis. There is still no effective treatment to cure or slow its progression. The best approach remains early diagnosis, conservative drug treatment, and injury prevention to avoid local ossification., Patient Concerns: A 34-year-old male presented at our hospital because of trismus caused by ossification of the masseter muscle. In addition, he had serious stiffness and multiple bony masses throughout the body, which led to limited movement., Diagnoses: Based on the clinical manifestation of movement restriction, characteristic radiographic images of ossification of soft tissues, the genetic test showing a heterozygous molecule (c.974G > C, p.G325A) of the activin A receptor type I, the patient was diagnosed as FOP complicated with localized MO in masseter after trauma and infection., Interventions: The patient underwent the surgical resection of ossification in the masseter muscle, he was instructed to insist on mouth-opening exercises and take glucocorticoids and nonsteroidal anti-inflammatory medications after surgery., Outcomes: The symptoms of trismus are relieved, and eating can be basically achieved after surgery, while the symptoms of trismus recurred 2 years later., Lessons: Although FOP has unique clinical manifestations, its diagnosis may be difficult because of its rarity. Gene analysis is the main standard for diagnosis, while patients with different genotypic variations may show different clinical symptoms. Therapeutic interventions are still supportive and preventive, and surgery is not recommended except under certain circumstances., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

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., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Objective: This paper aims to: (1) document a rare femoral heterotopic ossification (HO), and (2) discuss its aetiology and impact on the individual's locomotion and daily living activities., Materials: Adult female skeleton (SG.14-SK.7) from the village of Constância (Portugal), and dated from the 14th-19th centuries CE., Methods: The biological profile and the macroscopic analysis of the bone changes were assessed using standardized methods., Results: The macroscopic analysis revealed a large bony mass (8 cm length) located immediately inferior to the small trochanter of the right femur. The lesion exhibited a compact, tubular appearance located at the site of attachment of the pectineus muscle. No signs of bone fracture were observed., Conclusions: The morphology of the SG.14-SK.7 femoral lesion is compatible with a probable case of myositis ossificans traumatica (MOT), secondary to acute trauma of the pectineus muscle. The underlying trauma episode, such as random accidental and/or occupation-related injury, is unknown. However, it is highly possible that this self-limiting condition significantly impaired the individual's daily life and mobility., Significance: Evidence of severe acute muscle trauma is a rare finding compared with HO secondary to bone trauma and other minor muscle injuries. Moreover, no cases of MOT affecting the pectineus muscle have been reported in the paleopathological literature to date., Limitations: Although unlikely, a case of neurogenic or burn-related HO cannot be completely disregarded. It was not possible to undertake radiography as part of this study., Suggestions for Further Research: The use of imaging techniques to complement the paleopathological description is advised., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Myositis ossificans (MO) is a benign heterotopic bone formation in muscle or soft tissue. It is a self-limiting disease that is usually initiated by trauma and often occurs in the extremities of the body. Here we report a rare case of traumatic myositis ossificans caused by unusual trauma (extracorporeal shock wave therapy) at thoracic paraspinal muscles. After a needle biopsy, the lesion increased in size, and the patient's symptoms worsened. Malignant soft tissue tumors such as osteosarcoma should be differentiated, so excision of the mass was performed. The final diagnosis was MO with aneurysmal bone cystic change. This case is a very rare form of MO that showed an unusual cause, location, clinical course, and pathologic result on follow-up. This can be an instructive case for radiologists as it is a common disease entity with unusual manifestations.

Competing Interests: The authors declare no conflict of interest.

Background: Traumatic myositis ossificans is a self-limited, non-neoplastic, ectopic bone formation in the soft tissues caused by trauma. Conservative treatment is the mainstay of management. However, open surgery and complete resection should be considered in patients with limited joint function and constant pain. Herein, we retrospectively analyzed the outcome of open surgical resection in children with myositis ossificans (MO)., Methods: The data of patients diagnosed with MO between February 2010 and May 2019 were retrospectively analyzed. The clinical data included medical history, physical examination, and laboratory, imaging, and pathological findings. All patients underwent an open surgery and total resection. Radiography findings and joint function were evaluated. Patients with developing complications, such as recurrence and assessing joint function, were followed up. In total, 20 patients (sex, 15 male and 5 female patients; age, 8.1 ± 2.5 years) were included., Results: MO was located around the elbow, wrist, proximal humerus, and thigh in 13, one, one, and five patients, respectively. All patients were followed up for > 12 months. Two patients had partial recurrence after surgery. One patient with forearm MO had poor elbow function (Broberg-Morrey score of 70). Nineteen patients had good functional outcomes according to the Broberg-Morrey and Cooney methods., Conclusion: Open surgical resection is an effective method for children with MO. The recurrence rate was low when the surgery was performed after the acute stage (1.5 months from disease presentation)., (© 2021. The Author(s) under exclusive licence to SICOT aisbl.)

Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare progressive genetic disease effecting one in a million individuals. During their life, patients with FOP progressively develop bone in the soft tissues resulting in increasing immobility and early death. A mutation in the ACVR1 gene was identified as the causative mutation of FOP in 2006. After this, the pathophysiology of FOP has been further elucidated through the efforts of research groups worldwide. In 2015, a workshop was held to gather these groups and discuss the new challenges in FOP research. Here we present an overview and update on these topics., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 de Ruiter, Smilde, Pals, Bravenboer, Knaus, Schoenmaker, Botman, Sánchez-Duffhues, Pacifici, Pignolo, Shore, van Egmond, Van Oosterwyck, Kaplan, Hsiao, Yu, Bocciardi, De Cunto, Longo Ribeiro Delai, de Vries, Hilderbrandt, Jaspers, Keen, Koolwijk, Morhart, Netelenbos, Rustemeyer, Scott, Stockklausner, ten Dijke, Triffit, Ventura, Ravazzolo, Micha and Eekhoff.)

Abstract: Myositis ossificans traumatica is a rare condition in which causes restriction of mandibular movement. In this entity, temporomandibular joint is depleted of any problems; although all the patients have the history of trauma to the mandible and the face. Myositis ossificans traumatica can involve other parts of the body like femoral region with higher incidence in compare to the maxillofacial area. Blunt trauma to the head and neck causes muscle contusion injury, hematoma formation in the injured muscles or nearby soft tissues. Calcification of hematoma and heterotopic bone formation in the muscle, soft tissue, or near bony structures causes progressive decrease in mouth opening. Surgical removal of calcified body has been the only and one method for treatment of this disorder but rate of recurrence is high in the literature. The authors want to introduce 2 new cases of myositis ossificans traumatica, and then discuss about etiology and different treatment modalities., Competing Interests: The authors report no conflicts of interest., (Copyright © 2021 by Mutaz B. Habal, MD.)

Myositis ossificans (MO) is a condition where calcification occurs in the soft tissue as well as around the bone following fracture, vigorous exercise or trauma. Although it is a radiological diagnosis, it often leads physician to an incorrect or missed diagnosis as recurrent fracture. Frequently, it follows haemorrhage into the muscle in the tissue space. We report a 45 years old house-wife presented with the complaints of weakness of right side of body and pain with restricted range of motion (ROM) in right lower limb. She was a diagnosed case of recurrent stroke with rheumatic valvular heart disease. After discharge, vigorous physical exercise was done at home by local physiotherapist without appropriate guidance from physiatrist. Gradually pain was so severe that she didn't allow moving her right lower limb. Over the course of time, she became incapacite and bed bound. She denied any positive family history. With the hip and lower limb problems she consulted with orthopedic surgeon and was referred to Physical Medicine and Rehabilitation department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh for further management & rehabilitation. This case is presented to focus on hazard of being unguided, over-exercised and non-surgical management approach of this rare condition.

Athletes involved in contact sports can be diagnosed with traumatic myositis ossificans. Myositis ossificans is characterised by a benign ossifying lesion in soft tissue mass, most commonly preceded by a muscle contusion in the thigh. Despite the fact that it is often a self-limiting disease, treatment modalities are anti-inflammatory drugs, physiotherapy, shockwave therapy, radiation therapy or surgical resection. We report a 22-year-old competitive football player with severe ongoing pain in the lower leg after a direct trauma. An X-ray showed calcification between the tibia and fibula. An additional ultrasound confirmed the diagnosis: myositis ossificans of the tibialis anterior muscle. After treating him with anti-inflammatory drugs and physiotherapy, he was able to return to sports. Myositis ossificans of the lower leg is an uncommon, though if present, troublesome condition, occurring after a contusion., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

A football player was diagnosed with myositis ossificans of his right adductor longus muscle after an acute injury. Conservative treatment failed and 1 year after the initial trauma the patient underwent surgical excision of a large ossification. Seven months postoperatively, the patient was fully recovered and returned to his preinjury activity levels. We present our approach to this case and discuss our considerations, referring to background information about this rare disease., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2020. Re-use permitted under CC BY. Published by BMJ.)

Myositis ossificans traumatica (MOT) is a common form of heterotopic ossification associated to trauma. Rare mature manifestations and topographically atypical presentations of MOT are often misdiagnosed as osteosarcoma. This case study discusses a rare, mature case of MOT of the piriformis muscle, potentially clinically associated with piriformis syndrome. The ossification was observed on a dry sacral bone of an adult skeleton belonging to a South African male during routine inventory of the Raymond A. Dart Collection of Human Skeletons, the University of the Witwatersrand, Johannesburg. The MOT was located on the anterior aspect of the sacrum at a site corresponding to the upper portion of the origin of the muscle and extended laterally towards the greater trochanter, beyond the greater sciatic notch. It was cylindrical in shape and measured approximately 52.70 mm in length and 12.10 mm in diameter. Micro-focus CT revealed an extensive and mature bony development of the piriformis muscle with distinct outer cortical and inner trabecular bone. In addition, the skeleton showed widespread healed skeletal trauma, suggesting a history of trauma. The MOT was completely fused to the sacral bone excluding the possibility of congenital anomalies. Information on the MOT of the piriformis muscle is vital to clinicians and radiographers to aid in successful diagnosis and management of the piriformis syndrome and sciatica in the gluteal region. This case also provides a rare example to biological anthropologists, paleoanthropologists and bioarchaeologists of the representation of pathologies like these on a dry bone sample.

Overuse myositis ossificans is considered an extremely rare diagnosis, with only a few cases reported so far. A case of a 54-year-old firefighter, involved regularly in training exercises, with bilateral myositis ossificans of the triceps, is presented. The patient had a 4 year history of painful masses at the posterior region of both arms. He never experienced any traumatic event, while physical examination revealed firm masses extending longitudinally within the lateral head of the triceps, bilaterally. The patient had painful restricted range of motion at both sides. Plain X-ray views of the humerus showed linear lobulated heterogeneous masses posterolateral. Surgical resection of both masses, which extended intramuscularly through the whole lateral triceps' head, was performed. Histological examination confirmed the diagnosis of myositis ossificans. Myositis ossificans represents a benign, relative rare clinical entity, defined as heterotopic ossification of the soft tissues. Only 5 cases of myositis ossificans due to overuse have been described so far. The present case is unique, since it is the first one describing bilateral appearance of two masses which extended through the whole length of the lateral head of the triceps. A detailed medical history, as well as imaging examination seem to be necessary in order to establish the diagnosis. Treatment should be decided upon the stage of the lesion. For mature lesions surgical treatment is advised.

Purpose: This study analyzes Prx1-specific conditional knockout of Acvr1 aiming to elucidate the endogenous role of Acvr1 during limb formation in early embryonic development. ACVR1 can exhibit activating and inhibiting function in BMP signaling. ACVR1 gain-of-function mutations can cause the rare disease fibrodysplasia ossificans progressiva (FOP), where patients develop ectopic bone replacing soft tissue, tendons and ligaments., Methods: Whole-mount in situ hybridization and skeletal preparations revealed that following limb-specific conditional knockout of Acvr1, metacarpals and proximal phalanges were shortened and additional cartilage and bone elements were formed., Results: The analysis of a set of marker genes including ligands and receptors of BMP signaling as well as genes involved in patterning and tendon and cartilage formation, revealed temporal disturbances with distinct spatial patterns. The most striking result was that in the absence of Acvr1 in mesoderm precursor cells, first digits were drastically malformed., Conclusion: In FOP, malformation of big toes can serve as a first soft marker in diagnostics. The surprising similarities in phenotype between the described conditional knockout of Acvr1 and the FOP mouse model, indicates a natural inhibitory function of ACVR1. This represents a further step towards better understanding the role of Acvr1 and developing treatment options for FOP., (© 2019 The Authors. Developmental Dynamics published by Wiley Periodicals, Inc. on behalf of American Association of Anatomists.)

Myossitis ossificans (MO) is a benign disorder characterized by heterotopic bone formation in skeletal muscle. It is divided in three types, fibrodysplasia ossificans progressive (FOP), myositis ossificans circumscripta or traumatica (MOT) and myositis ossificans without a history of trauma (non traumatic or pseudomalignant MO). Myositis ossificans is extremely rare in children younger than 10 years. We present the clinical and radiological findings of two 5-year-old children with pseudomalignant MO due to prolonged immobilization. Plain x-ray films and CT scan with their characteristic findings of mature bone in the periphery of the lesion with smooth contour and well separated from the bone, enabled us to diagnose the lesion. To the best of our knowledge, no such cases have been reported in the literature.

Fibrodysplasia ossificans progressiva (FOP) is a rare human skeletal disease caused by constitutively activating mutations in the gene ACVR1, which encodes a type I BMP/TGFβ family member receptor. FOP is characterized by progressive heterotopic ossification (HO) of fibrous tissues, including skeletal muscle, tendons, and ligaments, as well as malformation of the big toes, vertebral fusions, and osteochondromas. Surgical interventions in patients often result in enhanced HO, which can exacerbate rather than improve diagnostic outcomes. As a result of these difficulties, a variety of animal models are needed to study human FOP. Here we describe the methods for creating and characterizing zebrafish conditionally expressing Acvr1l Q204D , the first adult zebrafish model for FOP.

Fibrodysplasia ossificans progressiva (FOP), a rare genetic disorder of progressive extra-skeletal ossification, is the most disabling form of heterotopic ossification (HO) in humans. Most people with FOP carry an activating mutation in a BMP type I receptor gene, ACVR1 R206H , that promotes ectopic chondrogenesis and osteogenesis and in turn HO. Advances in elucidating the cellular and molecular events and mechanisms that lead to the ectopic bone formation are being made through the use of genetically engineered mouse models that recapitulate the human disease. We describe methods for inducing heterotopic ossification in a mouse model that conditionally expresses the Acvr1 R206H allele.

Myositis ossificans (MO) is a rare non-neoplastic disorder characterized by heterotopic ossification in soft tissues, mainly muscles. MO traumatica is characterized by ossification of the soft tissues after acute or repetitive trauma, burns, or surgical intervention. Muscular or soft tissue trauma is usually present as the underlying etiology. MO traumatica usually involves the extremity muscles. The number of reported cases involving the masticatory muscles is extremely low. The most common clinical sign of this condition is progressive limitation of mouth opening. Surgical resection of the ossified tissue has been the most commonly used treatment for this disorder, with a high postoperative recurrence rate. We report a case of traumatic MO of the medial pterygoid muscle to draw attention to the possibility of the condition in patients with a limited mouth opening and to review the reported data about MO traumatica involving the medial pterygoid muscle., (Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Background: Myositis ossificans describes a heterotopic bone formation within a muscle. Thereby myositis ossificans is classified in two different groups: myositis ossificans progressiva (MOP) which describes a genetic autosomal dominant rare disease and myositis ossificans traumatica (MOT). The exact pathogenesis of MOT is unclear. The aim of this article was to analyse and interpret the existing literature reporting MOT of masticatory muscles and compare the results with our own clinical experience with MOT. Risk-factors, etiology, clinical features, diagnostic imaging, as well as different treatment options were evaluated and recommendations for the prevention, diagnosis, and therapy of MOT of the masticatory muscles were given., Methods: Following the PRISMA-Guidelines, a systematic search within the PubMed/Medline database with a view to record literature of MOT of the masticatory muscles was performed. Furthermore, the database of our own clinic was screened for cases of MOT., Results: In total, 63 cases of MOT of the masticatory muscles which were reported in English-based literature were included in this study. Overall, 25 female and 37 male patients could be analysed whereas one patient's gender was unknown. Complication of wisdom-tooth infection (n = 3) as well as the results of dental procedures like dental extraction (n = 7), mandibular nerve block (n = 4), periodontitis therapy (n = 1) were reported as MOT cases. From the 15 reported cases that appeared after dental treatment like extraction or local anesthesia the medial pterygoid (n = 10) was the most affected muscle. Hereof, females were more affected (n = 9) than males (n = 6). The most reported clinical symptom of MOT was trismus (n = 54), followed by swelling (n = 17) and pain (n = 13). One clinical case provided by the authors was detected., Conclusions: Dental procedures, such as local anesthesia or extractions, may cause MOT of the masticatory musculature. Demographical analyses demonstrate that females have a higher risk of developing MOT with respect to dental treatment. The most important treatment option is surgical excision. Subsequent physical therapy can have beneficial effects. Nevertheless, a benefit of interpositional materials and drugs as therapy of MOT of the masticatory muscles has not yet been proven. Myositis ossificans progressiva has to be excluded.

A 39-year-old male nonprofessional cyclist presented to physical therapy reporting deep, stabbing, anterolateral left thigh pain. Clinical findings led the physical therapist to request radiographs, which revealed myositis ossificans in the left thigh. J Orthop Sports Phys Ther 2018;48(5):420. doi:10.2519/jospt.2018.7567.

Fibrodysplasia ossificans progressiva (FOP) is a rare genetic condition characterized by progressive extra-skeletal ossification leading to cumulative and severe disability. FOP has an extremely variable and episodic course and can be induced by trauma, infections, iatrogenic harms, immunization or can occur in an unpredictable way, without any recognizable trigger. The causative gene is ACVR1 , encoding the Alk-2 type I receptor for bone morphogenetic proteins (BMPs). The signaling is initiated by BMP binding to a receptor complex consisting of type I and II molecules and can proceed into the cell through two main pathways, a canonical, SMAD-dependent signaling and a p38-mediated cascade. Most FOP patients carry the recurrent R206H substitution in the receptor Glycine-Serine rich (GS) domain, whereas a few other mutations are responsible for a limited number of cases. Mutations cause a dysregulation of the downstream BMP-dependent pathway and make mutated ACVR1 responsive to a non-canonical ligand, Activin A. There is no etiologic treatment for FOP. However, many efforts are currently ongoing to find specific therapies targeting the receptor activity and the downstream aberrant pathway at different levels or targeting cellular components and/or processes that are important in modifying the local environment leading to bone neo-formation., Competing Interests: The authors declare no conflict of interest.

Fibrodysplasia ossificans progressiva (FOP) is a rare autosomal-dominant disorder characterized by progressive and profoundly disabling heterotopic ossification (HO). Here we show that fibro/adipogenic progenitors (FAPs) are a major cell-of-origin of HO in an accurate genetic mouse model of FOP (Acvr1 tnR206H ). Targeted expression of the disease-causing type I bone morphogenetic protein (BMP) receptor, ACVR1(R206H), to FAPs recapitulates the full spectrum of HO observed in FOP patients. ACVR1(R206H)-expressing FAPs, but not wild-type FAPs, activate osteogenic signaling in response to activin ligands. Conditional loss of the wild-type Acvr1 allele dramatically exacerbates FAP-directed HO, suggesting that mutant and wild-type ACVR1 receptor complexes compete for activin ligands or type II BMP receptor binding partners. Finally, systemic inhibition of activin A completely blocks HO and restores wild-type-like behavior to transplanted Acvr1 R206H/+ FAPs. Understanding the cells that drive HO may facilitate the development of cell-specific therapeutic approaches to inhibit catastrophic bone formation in FOP.

We report a case of an 18-year-old woman, with bilateral acute inflammatory pain on the hip area, during the premenstrual period, and progressive increase in volume and rigidity of both hips. Bilateral exuberant soft tissue calcifications were present on the radiographic exams, and the patient also presented with bilateral short-length hallux valgus. A heterozygous mutation in the protein kinase domain of ACVR1 gene was found, allowing the diagnosis of fibrodysplasia ossificans progressive. Due to the relation between the disease flares and the premenstrual period, the patient was put into a chemically induced amenorrhea, with no new inflammatory crises since.This case illustrates the importance of an accurate diagnosis to prevent unnecessary diagnostic procedures, as well as the need to develop specific treatment strategies to address each patient's particular needs., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

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., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Background: Upper cervical spine fractures are traumatic injuries typically associated with high-energy trauma and have a high morbidity and mortality rate. We describe a case of upper cervical spine fracture occurring due to high-energy trauma that resulted in significant myositis ossificans (MO) of the longus coli muscle., Study Design: Case Report and literature review., Methods: Retrospective review of medical records., Results: The patient was treated non-operatively for the neck rotation and MO of his longus coli muscle and had gradual improvement of symptoms., Conclusions: To our knowledge, this is the first report of symptomatic MO of the longus coli following traumatic cervical spine fracture in an adult. Treatment with supportive measures appears to achieve satisfactory outcome.

A 77-year-old male who had had an olecranon fracture 15 years ago presented himself with mild pain of the right elbow. Physical examination revealed painless hardening of the finger and wrist flexors in an area of 10 cm from the origin. Conventional radiographs showed a mature myositis ossificans.

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.

Traumatic myositis ossificans (TMO) is a rare ossifying disease that occurs in the muscle or soft tissues. A case of TMO isolated in the temporalis muscle is reported. In the case described, calcification in the temporalis muscle was confirmed after computed tomography. Surgery, physiotherapy, and histopathological analysis were performed. One year after treatment, further ossification was present but without interference in function. The most accepted treatment for TMO in the maxillofacial region is excision followed by physiotherapy. The high rate of non-recurrence may be concealed due to the short follow-up period. TMO is a lesion that may frequently recur and long-term follow-up must be provided.

Objective: Myositis ossificans is a worrisome complication of muscle lesions in sports medicine. Our goal is to specify clinical, paraclinical and therapeutic elements to guide a myositis ossificans traumatica patient back into sport., Method: All patients having consulted between January 2006 and December 2012 presenting myositis ossificans with a recent muscle injury from playing sports were included. We excluded patients with myositis ossificans without an identified trauma, or from an old injury (>6 months). Ultrasound images were captured on a Philips(®) Sparq ultrasound machine with a linear probe (4-12MHz). The diagnosis of myositis ossificans was performed on 2 ultrasound criteria in context of recent muscle trauma: presence of ossification or calcification within a muscle on axial and longitudinal sections using B-mode and hyperactivity in power Doppler mode around the ossification/calcification. Clinical signs and treatment were collected systematically at inclusion, 6 months and 1 year., Results: Among the 22 myositis ossificans cases diagnosed between January 2006 and December 2012, 19 were of traumatic origin, on a recent muscle lesion and were included in the study. Our patients resumed light physical activities 3 months after diagnosis for 89.5% of them (100% at 10 months) and returned to their earlier level 6 months after myositis ossificans diagnosis for also 89.5% of them (all patients having resumed sport at their earlier levels 12 months after diagnosis)., Conclusion: Therapeutic abstention and persistence of ossification do not seem to be detrimental factors for resuming a sport at the earlier level with ultrasound monitoring., (Copyright © 2016 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.)

Posttraumatic myositis ossificans (PTMO) is the most common form of myositis ossificans, but it rarely affects the hand. Due to the aggressive behavior of this unusual tumor, it is commonly misdiagnosed as malignancy or local infection. This report describes a case of PTMO of the hand in a 25-year-old women, and reviews the clinical, radiologic, and histologic characteristics. By understanding the disease characteristics and maturation process, physicians can avoid a misdiagnosis that may lead to functional impairment or improper treatment.

Computer-assisted surgery is now a common procedure in the field of orthopedics. We present two patients who developed myositis ossificans, a rare complication after navigated knee surgery. Due to careful follow-up and conservative treatment, surgical excision was avoided in both patients with good clinical results. Development of myositis ossificans after navigated knee surgery should be considered in cases of thigh pain and restricted range of motion of the knee., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Background: Myositis Ossificans Cicumscripta is a rare condition characterized by aberrant bone formation in paramuscular soft tissue of the extremities usually associated with trauma or a genetic mutation. Very few cases involve the head or neck and it is rarely found in the pediatric population., Objectives: We present a case of a 5-month old with a rapidly growing posterior neck mass suspicious for neoplasia, which was treated with surgical resection and found to be a non-traumatic, non-genetic form of Myositis Ossificans. The workup, treatment, and findings of the patient are outlined and a review of the literature on this disease is discussed., Conclusion: Myositis Ossificans is characterized by aberrant bone formation typically occurring after trauma but may be secondary to an underlying genetic abnormality. The case presented in the absence of trauma or an underlying genetic abnormality and is therefore an exceedingly rare instance of the sporadic form that presented spontaneously in the head and neck of a pediatric patient., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Fibrodysplasia ossificans progressiva is a rare disorder of heterotopic ossification. Procedures like biopsy and surgery are known to be aggravating factors in promoting heterotopic ossification Clues to clinical diagnosis may therefore be a great advantage to treating orthopedician. Valgus deformity of great toe is an important diagnostic clue for treating physicians and thus aids in preventing the clinicians from subjecting the patients to unnecessary invasive and traumatic procedures. Hence clinical clues to early diagnosis are important in establishing the correct diagnosis and directing future management.

Unlabelled: Heterotopic mesenteric ossification is a rare clinical entity with less than 40 reported cases. Moreover, heterotopic mesenteric ossification around a stoma is described in fewer cases., Case Presentation: An 81-year-old male patient, who underwent a sigmoidectomy two years ago for a sigmoid colon cancer, was admitted in our Department in order to be investigated for a local recurrence of his disease. Because of unresectable pelvic lesions, the patient was taken in the operating room for a palliative double barrel ileostomy. The patient presented two weeks after the ileostomy clinical signs suggesting its obstruction. A revision of the ileostomy is performed. Macroscopically, the end part of the ileostomy was inflamed and resected. Histological findings revealed heterotopic ossification of the mesentery., Conclusions: The surgeon should be alert to the possibility of heterotopic ossification, especially within a previously operated wound and be prepared for the difficulties it may cause during reopening of an incision, during the operation itself, at closure of the wound and, if not removed, also in the postoperative setting.

A young soccer player was diagnosed with myositis ossificans 6 weeks after a muscle strain in the right thigh. Radiographic and sonographic investigations initially helped to confirm diagnosis and later supported clinical improvement. We present our approach to the case and discuss pathophysiology, prevention and treatment of this rare condition., (2015 BMJ Publishing Group Ltd.)

An 18-year-old man presented with mid left thigh pain after sequential lacrosse injuries 1 month and 2 weeks prior. Physical examination was significant for a tender mass in the mid left thigh., (Copyright 2015, SLACK Incorporated.)

Introduction: Myositis ossificans usually occurs in the vicinity of the elbow, knee joints, or hip joints, following obvious trauma or surgery. This is the first report on myositis ossificans of the serratus anterior., Case Presentation: In this report we present a case of myositis ossificans within the serratus anterior which developed as a complication due to long-term nape massage. The patient was a 29-year-old Han woman. Because heterotopic ossificans constricted her brachial plexus the surface of her right upper arm was slightly numb; the symptom disappeared after surgery., Conclusion: This case highlights that myositis ossificans can occur in the serratus anterior following long-term nape massage.

Fractures of the transverse processes in the lumbar vertebrae occur as the result of major forces such as direct blunt trauma, violent lateral flexion-extension forces, avulsion of the psoas muscle, or Malgaigne fractures of the pelvis. Dancers make repeated and forceful hyperextension and flexions of the spine, which may cause fractures of the transverse processes of the lumbar vertebrae. Repeated trauma of muscles in dancers may cause avulsion fractures and myositis ossificans. Herein, we report MRI and CT findings of an avulsion from the right transverse process of the L2 and L3 vertebrae in a 16-year-old professional teenage dancer, who responded to conservative treatment.

Myositis ossificans (MO) is a rare disease involving heterotopic ossification in the muscle or soft tissue. Myositis ossificans traumatica (MOT) disease presents as a calcification within the injured muscle, resulting from a single or repetitive injury. There are few reports of MOT in the masticatory muscles. The case of a patient with MOT in the medial pterygoid muscle caused by a complication related to the extraction of an erupted upper third molar is reported. The major symptom was severe trismus. Despite surgical treatment, the disease relapsed. MOT can lead to serious consequences for the patient. Its aetiopathogenesis needs to be better understood, so that the most appropriate treatment is established and relapses are minimized. This will improve the quality of life of these patients., (Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

With a well-established incidence of 15% to 20% following a spinal injury, the occurrence of neurogenic myositis ossificans of the hip is quite rare. The most widely accepted theory supporting its occurrence is the repeated microtrauma by forceful passive mobilization during rehabilitation. An extensive involvement around the hip is quite disabling to the patient. We present the case of a 41-year-old man with an extensive involvement of the right iliopsoas following an incident of head injury with no primary injury to the hip, with a disabling restriction of movement. Computed tomography images and its 3D reconstruction were used to define the exact extent of involvement. The mass was excised piece meal using the iliofemoral approach with an osteotomy of the anterior superior iliac spine, which allowed us to have a better visualization to the extensive mass. Postoperatively the patient regained a good range of motion. In addition to adding a rare case of atraumatic myositis ossificans of the iliopsoas to literature, this reports describes a novel approach for its excision.

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.

Fibrodysplasia ossificans progressiva is the most severe and disabling disorder of ectopic ossification in humans. It is characterized by congenital skeletal abnormalities in association with extraskeletal widespread endochondral osteogenesis. Virtually all patients show the same mutation in the "Activin A type-I/activin-like kinase-2" receptor encoding gene. As a result of this discovery there have been significant advances in the knowledge of the cellular and molecular basis of the disease. Besides allowing a better understanding of ossification process, recent evidence indicates that the primary disturbance lies within basic mechanisms of cell differentiation that are key in several physiological pathways and in the genesis of diseases with a major impact on health. In this article we summarize these breakthroughs, with implications that go beyond the limits of this devastating disease to insinuate a new model of human pathophysiology., (Copyright © 2013 Elsevier España, S.L.U. All rights reserved.)

Myositis ossificans (MO) can be a significant complication of traumatic muscle contusion. Bisphosphates have been used in management of heterotopic ossification after spinal cord injury, but there is a lack of evidence with respect to MO in the sporting population. We present a case of a 14-year-old male football player with posttraumatic quadriceps MO, treated with 2 doses of intravenous pamidronate. This was associated with improvement in clinical features and imaging and a reduced urinary N-terminal telopeptide, a marker of bone turnover. This case demonstrates that bisphosphonates may be a potential treatment option in MO.

A 40-year-old male weightlifter presented with a 6-month history of a painless mass in the right deltoid. He had no history of trauma to the shoulder other than an arthroscopic rotator cuff repair a few weeks earlier. Physical examination showed a firm, nontender mass located longitudinally and coinciding with the deltoid, measuring 12×14×4 cm. There was no limitation in range of motion or functioning. Magnetic resonance imaging (MRI) and computed tomography (CT) scans suggested a lobulated, heterogeneous mass with multiple areas of calcification that raised suspicion for soft tissue sarcoma vs myositis ossificans. Marginal resection of the soft tissue mass was performed, and pathologic studies confirmed the diagnosis of xanthogranulomatous myositis ossificans with dystrophic calcifications and central cystic degeneration. At 2-week follow-up, the patient had improved range of motion and pain, but he noted a second soft tissue mass in the left deltoid. The MRI and CT scans showed a 10.5×16×3.4-cm linear, lobulated lesion with multiple calcifications, similar in appearance to the contralateral deltoid. The patient admitted to frequently injecting anabolic steroids into his deltoids. Because the patient was asymptomatic on the left side and the MRI appearance of the left deltoid mass was similar to that of the myositis ossificans seen on the right side, the patient opted for nonsurgical treatment. This is a rare case of myositis ossificans occurring bilaterally in the deltoids after repeated injections of anabolic steroids. There is currently no known association between anabolic steroids and myositis ossificans. This condition often mimics malignant neoplasms, illustrating the necessity of resection for diagnostic confirmation., (Copyright 2014, SLACK Incorporated.)

Tuberous sclerosis complex (TSC) is a multisystem disorder resulting in hamartomatous lesions. Despite diverse manifestations, skeletal muscular comorbidity is rarely reported in TSC. We report a 2-year-old girl with TSC who suffered from multiple subcutaneous masses over the paraspinal and bilateral scapular areas, which caused disabling pain on any passive movement. Three-dimensional computed tomography scanning revealed multiple calcifications that were consequently diagnosed as fibrodysplasia ossificans progressiva. Such imaging features should be evaluated cautiously to avoid unnecessary surgical intervention and biopsy that may worsen the condition., (Copyright © 2012. Published by Elsevier B.V.)