Advanced fibrodysplasia ossificans progressiva

Myositis ossificans progressive: case report

Myositis ossificans progressiva (MOP) is an autosomal dominant disorder. There is a progressive ectopic ossification and skeletal malformation, mainly in the connective tissue of muscle. The diagnosis is based on the clinical findings and radiological demonstration of the skeletal malformations. A 38-year-old female patient was admitted to our department with progressive increase of the thigh. Results of laboratory studies were normal. The radiography of the right thigh showed multiple intramuscular calcifications. Myositis ossificans progressiva should be diagnosed as early as possible and non-invasively, based upon history, clinical and radiological findings. Early and correct diagnosis is fundamental for indication of proper management of the disease.

Diagnostic features of fibrodysplasia (myositis) ossificans progressiva on bone scan

Fibrodysplasia ossificans progressiva (FOP) is a rare, autosomal dominant disorder of connective tissue that leads to progressive, disabling heterotopic ossification in characteristic anatomic patterns. It is accompanied by pathognomonic congenital malformation of the great toes (or thumbs) - microdactyly. There is a high occurrence of diagnostic errors in FOP, leading to inappropriate interventions that may result in significant harm to patients. Scintigraphic demonstration of heterotopic ossifications in connective tissue at characteristic locations, in combination with pathognomonic microdactyly of the great toes (or thumbs), is highly specific. The case presented here is aimed at increasing familiarity with those typical diagnostic features, especially on bone scintigraphy.

[Progressive myositis ossificans. Utility of bone scintigraphy]

47 year old woman affected by myositis ossificans, with muscular calcifications in her evolution. Bone scintigraphy showed increased polyfocal activity as well as uptake of different intensity in soft tissues. The bone scintigraphy allows for early identification of ossification areas in soft tissues, as it can even detect injuries earlier than that observed with other image techniques. It is considered to be very useful in the diagnosis and establishment of the extension of the process, as well as follow-up.

Fibrodysplasia ossificans progressiva: case report

Fibrodysplasia ossificans progressiva is a rare genetic disease characterized by widespread soft tissue ossification and congenital stigmata of the extremities. We report on a male child followed for ten years since the age of 3 years and 9 months, when the diagnosis was made. He was born with bilateral hypoplasic hallux valgus and ventricular septal defect, corrected by trans-sternal approach when 32 months old. Restriction of neck mobility followed and foci of ectopic ossification appeared. Four crises of disease exacerbation were treated with oral prednisone and/or other antiinflammatory drugs. Sodium etidronate 5 to 10 mg/kg/day was prescribed intermittently during about six years but was discontinued due to osteopenia. The disease course has been relentless, with severe movement restriction including the chest wall. A review showed few similar case reports in the Brazilian literature. We revisit the criteria for diagnosis and the essentials of management and treatment.