Srikanth I Muni, Vishal Amar, Kiran K Ravi
Department of Orthopaedics, ASRAM Medical College, Eluru, Godavari District, Andhra Pradesh, India.
J Orthop Case Rep. 2015 Jul-Sep;5(3):92-4. doi: 10.13107/jocr.2250-0685.321.
Myositis ossificans (MO), heterotopic ossification, occurs in muscles and soft tissue. This lesion contains actively proliferating fibroblasts and osteoblasts. It commonly affects vigorous young men and more so among athletes. It occurs as a result of trauma, either acute or chronic and can also arise near joints in neurological disorders. By time of presentation, ossification is extensive and the benign nature of the lesion is usually evident on radiological studies. Most common muscles involved in MO are the flexor muscles of the arm, the hamstrings and quadriceps femoris.
We present a case of MO with isolated involvement of rectus femoris in mid-thigh and sparing of other three muscles of quadriceps femoris, with no improvement following physiotherapy and medical management requiring surgical excision for better prognosis with no recurrence.
MO, a benign lesion, is known to affect the flexors of the arm, the hamstrings, and quadriceps femoris; it must be noted that even individual muscle can also be affected as shown in the above case presentation without involving whole group of muscles. Surgical excision is indicated if non-operative measures are not successful.
骨化性肌炎(MO)是一种异位骨化,发生于肌肉和软组织。该病变包含活跃增殖的成纤维细胞和成骨细胞。它通常影响精力充沛的年轻男性,在运动员中更为常见。其发生是由于急性或慢性创伤,也可在神经疾病的关节附近出现。在就诊时,骨化已广泛存在,病变的良性性质通常在影像学检查中很明显。骨化性肌炎最常累及的肌肉是手臂的屈肌、腘绳肌和股四头肌。
我们报告一例骨化性肌炎病例,仅累及大腿中部的股直肌,股四头肌的其他三块肌肉未受累,物理治疗和药物治疗后无改善,需要手术切除以获得更好的预后且无复发。
骨化性肌炎是一种良性病变,已知会影响手臂的屈肌(腘绳肌和股四头肌);必须注意的是,如上述病例所示,即使单个肌肉也可能受到影响,而不涉及整个肌肉群。如果非手术措施不成功,则需进行手术切除。