Kim Howard, Cheon Ji Hwan, Lee Dong Youl, Cheon Ji Hong, Cho Youn Kyung, Lee Sung Hoon, Kang Eun Young
Department of Rehabilitation Medicine, Kwangju Christian Hospital, Gwangju, Korea.
Ann Rehabil Med. 2017 Jun;41(3):498-504. doi: 10.5535/arm.2017.41.3.498. Epub 2017 Jun 29.
Extracorporeal shockwave therapy (ESWT) has been reported to be a safe and effective method for decreasing pain and relieving range of motion (ROM) limitations caused by neurogenic heterotopic ossification (NHO), though there has been no report that it might cause hematoma if applied to NHO. We hereby report a case of massive hematoma after ESWT, specifically the radial shockwave therapy (RSWT) device at both hips in a 49-year-old female patient with NHO. She had developed NHO after extensive subarachnoid hemorrhage. We had applied RSWT according to the previous report. The pain and the ROM limitations were gradually improved. Six weeks later, she reported pain and ROM limitations on the right hip. From a medial aspect, swelling and bruising of the right thigh could be seen. Magnetic resonance imaging and ultrasonography suggested a large hematoma between right hip adductor muscles. The symptoms disappeared after conservative treatment for one month, and subsequent follow-up imaging studies demonstrated resolution of the hematoma.
体外冲击波疗法（ESWT）据报道是一种安全有效的方法，可减轻由神经源性异位骨化（NHO）引起的疼痛并缓解活动范围（ROM）受限，尽管尚无关于其应用于NHO时可能导致血肿的报道。我们在此报告一例ESWT治疗后出现大量血肿的病例，具体是一名49岁患有NHO的女性患者双侧臀部使用径向冲击波疗法（RSWT）设备后出现的情况。她在广泛蛛网膜下腔出血后发生了NHO。我们根据先前的报告应用了RSWT。疼痛和ROM受限逐渐改善。六周后，她报告右髋部疼痛和ROM受限。从内侧看，可见右大腿肿胀和瘀伤。磁共振成像和超声检查提示右髋内收肌之间有一个大血肿。经过一个月的保守治疗后症状消失，随后的随访影像学研究显示血肿已消退。
