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Myossitis Ossificans
Myossitis Ossificans
Defn:
A benign tumour-like lesion characterized by osteoid & heterotopic bone formation in soft tissues or even beneath the periosteum.
CLASSIFICATION
Myositis ossificans traumatica
Post traumatic Localised to soft tissues affected by trauma Common 75%
1. Trauma - simple blow (contusion) -dislocation (injury during reduction) - avulsion (periosteal stripping in children) Fracture-short period of immobilisation
PATHOPHYSIOLOGY
Structures involved muscles, ligaments, tendons, fascia, periosteum Zone phenomena (Ackermann) 1. Central highly cellular- fibroblasts highly mitotic 2. Fibroelastic tissue 3. Mature well oriented bone
PATHOPHSYSIOLOGY CONTD.
Peculiar alteration in ground substance of connective tissue- proliferation of mesenchymal cells & metaplasia .Based on locationextraosseous, periosteal,parosteal
PATHOPHYSIOLOGY CONTD.
Degenerated & necrosed tissues are cleared off by macrophages
PATHOPHYSIOLOGY CONTD.
Cluster of nuclei in sarcoplasmic mass (giant cell tumour or myosarcoma)
This process begins at the periphery & gradually progresses toward the centre. Hence zone phenomenon. Ossification resorption may disappear by osteoclastic
When myositis ossificans is not removed it gets covered by a cartilagenous cap due to ms action (post traumatic osteochondroma)
Clinical features
Stretching of ms difficult-inelasticity & ms action difficultobstruction Hard mass may persist or undergo complete regression or post traumatic osteochondroma
Joints involved
o o
Rare congenital condition evident in childhood associated with disorders like Microdactyly, Brachydactyly, Klippel Feil etc. Starts as solitary firm mass in upper back(trapezius, lattissimus dorsi) but later other masses in soft tissues all over body Ossification takes place months or years later IP joints of foot & thumb as well as joints of spine may fuse Only lab finding raised ESR
MYOSITIS OSSIFICANS
MYOSITIS OSSSIFICATION
RECURRENCE AFTER SXZ
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