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    Go to the top of the page   ID: 20040607115925 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    | The Authors | Discussion | Write a Comment to this Case |
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    Myositis Ossificans Circumscripta
    H Rössler. Myositis Ossificans Circumscripta. PedRad [serial online] vol 4, no. 6.
    URL: www.PedRad.info/?search=20040607115925


     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are Ultrasound-images available for this case. [ Ultrasound ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    H. Rössler (Universität Leipzig)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    16 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    Leg-Muscular system / Connective tissue / Skin  

     
     Pediatric Radiology CasesMost likely etiology:

    unknown  

     
     Pediatric Radiology CasesHistory:

    Patient History: Acute pain on use in the left thigh. First admittance to our clinic was about 4 weeks ago. At time of presentation, the symptoms were already regressing. No known trauma.
    Local findings: Pain on pressure of the left thigh. No redness, no palpable resistance and no swelling.
    Lab: Inflammatory constellation (CRP 23 mg/l, BSR 42/82, Leukocytes 12 Gpt/l, Hb/Hk/Thrombocytes in normal range).  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    There are three theories of the development of this disease:
    1. Organized hematomas
    2. Chipping of the periost and osteoblast wandering across periostal gaps
    3. Connective tissue metaplasia.

    One differentiates between the different forms as, i.e. Traumatic m.o., atraumatic m.o. and neuropathic m.o.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Conventionally, one finds a circular calcified structure in the soft tissues.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: The calcified structures are seen in ultrasound as shadow-radiating lesions.



    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: The surrounding musculature is increased in echoes.



    MRI 1 <- view MRI 1

    MRI 1: T2 STIR: Representation of a bound, inhomogenically hyperintense RF in the soft tissues of the left thigh.




    MRI 2 <- view MRI 2

    MRI 2: In the T1-weighted image, the lesion is isointense with the muscle.




    MRI 3 <- view MRI 3

    MRI 3: T1 with fat saturation: Proof of a noticeable contrast media enhancement.




    MRI 4 <- view MRI 4

    MRI 4: T1 with fat saturation after administration of contrast media in the transversal slice through the lesion.


     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Surgery / Histo  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Rhabdomyosarcoma (MRI)
    Osteosarcoma (X-Ray)
    Progressive myositis ossificans as it's own illness.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    This is a benign process. It's course is phasic. In the early phases, proliferative fibroblasts cause a connective-tissue-like swelling of the tissue, which is followed by the intermediate phase (after 2 to 4 weeks) of development of an immature osteoid. In the late phase (after 6 to 24 months), mature lamellar bone is formed. The ossification is centripedal (in contrast to the ossification in osteosarcomas). Typically, a regression of the symptoms is seen in the course of disease. At the end, a spontaneous resorption or the incomplete regression can occur. Surgical intervention is only recommended if joints or nerves are involved, and when the lesion is mature.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    The disease was named by Dusch in 1868.
    The term "myositis ossificans" is not correctly chosen, since it is not for certain an inflammatory process, nor is the inflammatory process limited to the musculature.
    According to the definition, myositis ossificans includes all non-neoplastic, extraossic bone development in a location which is not meant to be.  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    Mandar A Pattekar, MD
    Myositis Ossificans
    www.emedicine.com/ped/topic1538

    2. Medline: Medline
    Henry DeGroot, MD
    Myositis Ossificans
    http://bonetumor.org/tumors/pages/page177.html

     

     
     Pediatric Radiology CasesKeywords:

    Circumscript myositis ossificans, heterotopic / ectopic ossification, Myositis Ossificans Circumscripta, Muscle pain, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    H Rössler. Myositis Ossificans Circumscripta. PedRad [serial online] vol 4, no. 6.
    URL: www.PedRad.info/?search=20040607115925  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Leg-Muscular system / Connective tissue / Skin
    or in the region: Leg
    or in the tissue/organ: Muscular system / Connective tissue / Skin
    or with the etiology: unknown
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are Ultrasound-images available for this case. [ Ultrasound ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Myositis Ossificans Circumscripta
    H Rössler. Myositis Ossificans Circumscripta. PedRad [serial online] vol 4, no. 6.
    URL: www.PedRad.info/?search=20040607115925


     

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    Myositis Ossificans Circumscripta
    Other cases by these authors:

    Search H. Rössler in Medline H. Rössler (1)   

    Myositis Ossificans Circumscripta  
     
    Myositis Ossificans Circumscripta
    H Rössler. Myositis Ossificans Circumscripta. PedRad [serial online] vol 4, no. 6.
    URL: www.PedRad.info/?search=20040607115925


     

    Which diagnosis have other collegues guessed?


    • Rhabdomyosarcoma
      Votes: 1 (6 %)


    • Extraossic osteosarcoma
      Votes: 1 (6 %)


    • Circumscript myositis ossificans
      Votes: 13 (86 %)


    • Purulent myositis
      Votes: 0 (0 %)



        Total answers: 15

     
    Myositis Ossificans Circumscripta
    H Rössler. Myositis Ossificans Circumscripta. PedRad [serial online] vol 4, no. 6.
    URL: www.PedRad.info/?search=20040607115925


     

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    Myositis Ossificans Circumscripta
    H Rössler. Myositis Ossificans Circumscripta. PedRad [serial online] vol 4, no. 6.
    URL: www.PedRad.info/?search=20040607115925


     




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