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de Faria LL, Babler F, Ferreira LC, de Noronha Junior OA, Marsolla FL, Ferreira DL. Soft tissue calcifications: a pictorial essay. Radiol Bras 2020; 53:337-344. [PMID: 33071378 PMCID: PMC7545731 DOI: 10.1590/0100-3984.2019.0100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Soft-tissue calcifications are extremely common. Because the imaging findings are nonspecific, soft-tissue calcifications are often problematic for radiologists, sometimes prompting unnecessary interventions. In addition, the nomenclature is quite confusing. Classically, soft-tissue calcifications are divided into four categories, by mechanism of formation-dystrophic, iatrogenic, metastatic, and idiopathic-depending on the clinical and biochemical correlation. However, it is also possible to classify such calcifications by compartment, and that classification can be quite useful in the radiological diagnostic assessment. In this article, we illustrate the main causes of soft-tissue calcifications, organizing them according to their anatomical and pathophysiological aspects, thus narrowing the differential diagnosis.
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Affiliation(s)
- Luisa Leitão de Faria
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil
| | - Fernanda Babler
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil
| | - Lorena Carneiro Ferreira
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil
| | | | - Felipe Lorenzo Marsolla
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil
| | - Dalton Libânio Ferreira
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil
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2
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Gupta N, Pruthi A, Kumar S, Verma R, Belho ES. Fibrodysplasia Ossificans Progressiva - A Rare Genetic Disorder and the Role of Technetium-99m Methylene Diphosphonate Bone Scan. Indian J Nucl Med 2019; 34:209-212. [PMID: 31293300 PMCID: PMC6593934 DOI: 10.4103/ijnm.ijnm_57_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Fibrodysplasia ossificans progressiva is a rare genetic disease believed to occur in approximately 1 in 2 million people worldwide and is characterized by progressive extraosseous ossification over the course of a lifetime in an inevitable and unpredictable episodic manner, with most patients being confined to a wheelchair by the third decade of life and requiring life-long care. The extraosseous calcification involves ligaments, tendons, muscles, and connective tissue leading to severe restriction of movements. Another hallmark of this condition is abnormal great toes. The diagnosis is often made on clinical and radiological examination, but Technetium-99m methylene diphosphonate (Tc-99m MDP) bone scan is usually indicated to determine the extent of the disease. We hereby present a case series comprising of four patients suffering from this debilitating illness who underwent Tc99m MDP bone scan for initial diagnosis and localizing sites of heterotopic ossification.
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Affiliation(s)
- Nitin Gupta
- Department of Nuclear Medicine and PET/CT, Mahajan Imaging Centre, Sir Ganga Ram Hospital, New Delhi, India
| | - Ankur Pruthi
- Department of Nuclear Medicine, Manipal Hospital, New Delhi, India
| | - Suneel Kumar
- Department of Nuclear Medicine and PET/CT, Mahajan Imaging Centre, Sir Ganga Ram Hospital, New Delhi, India
| | - Ritu Verma
- Department of Nuclear Medicine and PET/CT, Mahajan Imaging Centre, Sir Ganga Ram Hospital, New Delhi, India
| | - Ethel Shangne Belho
- Department of Nuclear Medicine and PET/CT, Mahajan Imaging Centre, Sir Ganga Ram Hospital, New Delhi, India
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3
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Bauer AH, Bonham J, Gutierrez L, Hsiao EC, Motamedi D. Fibrodysplasia ossificans progressiva: a current review of imaging findings. Skeletal Radiol 2018; 47:1043-1050. [PMID: 29445932 DOI: 10.1007/s00256-018-2889-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/28/2017] [Accepted: 01/12/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Fibrodysplasia ossificans progressiva is a rare genetic disorder characterized by congenital skeletal deformities and soft tissue masses that progress to heterotopic ossification. Deformities of the great toes are distinctive, and heterotopic ossification in the soft tissues follows an expected anatomic and temporal pattern. In addition to heterotopic ossification, osteochondromata, middle ear ossification, demyelination, lymphedema, and venous thrombosis are characteristic. Awareness of this constellation of findings is important to early diagnosis and surveillance. CONCLUSIONS Recognition of the imaging manifestations of fibrodysplasia ossificans progressiva is imperative to early diagnosis in order to appropriately direct patient care and preclude unnecessary biopsies or surgical procedures.
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Affiliation(s)
- Adam H Bauer
- Kaiser Fontana Medical Center, Fontana, CA, USA.
| | - Jeff Bonham
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Luis Gutierrez
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Edward C Hsiao
- Division of Endocrinology, Diabetes, and Metabolism and the Institute for Human Genetics, Department of Medicine, University of California, San Francisco, CA, USA
| | - Daria Motamedi
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
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4
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Talbi S, Aradoini N, Mezouar IE, Abourazzak FE, Harzy T. Myositis ossificans progressive: case report. Pan Afr Med J 2016; 24:264. [PMID: 27800117 PMCID: PMC5075454 DOI: 10.11604/pamj.2016.24.264.6670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 04/10/2015] [Indexed: 11/15/2022] Open
Abstract
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.
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Affiliation(s)
- Sofia Talbi
- Department of Rheumatology, University Hospital Hassan II, Fes, Morocco
| | - Nassira Aradoini
- Department of Rheumatology, University Hospital Hassan II, Fes, Morocco
| | - Iman El Mezouar
- Department of Rheumatology, University Hospital Hassan II, Fes, Morocco
| | | | - Taoufik Harzy
- Department of Rheumatology, University Hospital Hassan II, Fes, Morocco
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5
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Nitek Z, Czwojdziński A, Wolf-Kuś A, Walecki J. Computed tomography in the diagnosis of myositis ossificans - case report. Pol J Radiol 2014; 79:296-8. [PMID: 25210536 PMCID: PMC4159248 DOI: 10.12659/pjr.890511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 02/15/2014] [Indexed: 11/30/2022] Open
Abstract
Background The term myositis ossificans refers to the formation of ossifications in the muscles, ligaments and fascias, usually as a result of trauma. Fibrodysplasia ossificans progressiva is a rare genetic disease in which heterotopic ossifications appear in early childhood and are accompanied by feet and spine defects. Case Report We present a case of a 31-year-old woman with massive heterotopic ossifications who suffered multiple injuries. We would like to emphasize the role of computed tomography in the exact localization of ossifications. Conclusions Thanks to the volume rendering techniques and 3D image reconstructions, it is possible to precisely determine the position of ossifications in relation to the internal organs and blood vessels, allowing to schedule the surgery to remove the lesions.
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Affiliation(s)
- Zaneta Nitek
- Department of Imaging Diagnostics, Independent Public Clinical Hospital, Otwock, Poland
| | - Adam Czwojdziński
- Department of Orthopaedics, Independent Public Clinical Hospital, Otwock, Poland
| | - Alicja Wolf-Kuś
- Department of Imaging Diagnostics, Independent Public Clinical Hospital, Otwock, Poland
| | - Jerzy Walecki
- Department of Imaging Diagnostics, Independent Public Clinical Hospital, Otwock, Poland
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6
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de Moraes FB, de Queiroz Filho AR, da Silva LJ, da Rocha VL, Araújo NP, Mendonça EQ, de Almeida ÉP. MYOSITIS OSSIFICANS PROGRESSIVA: CASE REPORT. REVISTA BRASILEIRA DE ORTOPEDIA (ENGLISH EDITION) 2012; 47:394-6. [PMID: 27042654 PMCID: PMC4799426 DOI: 10.1016/s2255-4971(15)30119-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Accepted: 07/12/2011] [Indexed: 11/29/2022]
Abstract
Myositis ossificans progressiva is a rare autosomal dominant disease with less than 1,000 case reports. Such patients present edema, caused by inflammatory processes that progressively calcify, and with loss of mobility in the region affected. The objective of this study was to describe a case of myositis ossificans progressiva, present its clinical manifestations and discuss the treatments available (oral ascorbic acid and intravenous bisphosphonate).
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Affiliation(s)
- Frederico Barra de Moraes
- Substitute Assistant Professor of Orthopedics in the Department of Orthopedics and Traumatology, Clinical Hospital of the Federal University of Goiás, Goiãnia, GO, Brazil
- Correspondence: Departamento de Ortopedia, Hospital das Clínicas, Primeira Avenida, sem número, Setor Universitário, 74000-000 Goiãnia, GOCorrespondence: Departamento de OrtopediaSetor UniversitárioHospital das ClínicasPrimeira Avenidasem númeroGoiãniaGO74000-000
| | - Alano Ribeiro de Queiroz Filho
- Resident Physician in the Department of Orthopedics and Traumatology, Clinical Hospital of the Federal University of Goiás, Goiãnia, GO, Brazil
| | - Leonardo Jorge da Silva
- Resident Physician in the Department of Orthopedics and Traumatology, Clinical Hospital of the Federal University of Goiás, Goiãnia, GO, Brazil
| | - Válney Luiz da Rocha
- Head of the Pediatric Orthopedics Group, Department of Orthopedics and Traumatology, Clinical Hospital of the Federal University of Goiás, Goiãnia, GO, Brazil
| | - Nayara Portilho Araújo
- Trainee from the Trauma Students’ Association, Department of Orthopedics and Traumatology, Clinical Hospital of the Federal University of Goiás, Goiãnia, GO, Brazil
| | - Ernesto Quaresma Mendonça
- Trainee from the Trauma Students’ Association, Department of Orthopedics and Traumatology, Clinical Hospital of the Federal University of Goiás, Goiãnia, GO, Brazil
| | - Érica Paiva de Almeida
- Trainee from the Trauma Students’ Association, Department of Orthopedics and Traumatology, Clinical Hospital of the Federal University of Goiás, Goiãnia, GO, Brazil
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7
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Carvalho DR, Farage L, Martins BJAF, Speck-Martins CE. Craniofacial findings in fibrodysplasia ossificans progressiva: computerized tomography evaluation. ACTA ACUST UNITED AC 2011; 111:499-502. [PMID: 21420641 DOI: 10.1016/j.tripleo.2010.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2010] [Revised: 11/05/2010] [Accepted: 12/14/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim of this study was the evaluation by using computerized tomography (CT) of craniofacial abnormalities in fibrodysplasia ossificans progressiva (FOP) patients regarding jaw restriction and retrognathia. STUDY DESIGN Seven FOP patients were evaluated retrospectively in this observational study. Inclusion criteria were detection of ACVR1 gene mutation and complete craniofacial CT examination. The age of jaw restriction and presence of retrognathia were clinically determined. The features analyzed were skull base structures and heterotopic ossification (HO). RESULTS Of this group (age range 4-23 years), the 3 oldest patients presented with jaw restriction and retrognathia as well as displayed elongation of the lateral pterygoid plate with HO of the pterygoid muscles that reached the medial surface of the right mandibular ramus. They had significant history of trauma or surgery. The other 4 patients did not have retrognathia or HO involving the facial or masticatory muscles, and the mouth opening was normal. CONCLUSIONS CT evaluation can reveal HO of the pterygoid muscles that probably may cause jaw restriction and retrognathia in older FOP patients.
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8
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Asano K, Sakata A, Shibuya H, Kitagawa M, Teshima K, Kato Y, Sasaki Y, Kutara K, Seki M, Edamura K, Sato T, Tanaka S. Fibrodysplasia ossificans progressiva-like condition in a cat. J Vet Med Sci 2006; 68:1003-6. [PMID: 17019075 DOI: 10.1292/jvms.68.1003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Fibrodysplasia ossificans progressiva (FOP)-like condition was diagnosed in a Japanese domestic cat with stiffness, marked atrophy of the muscles, and limited mobility of all joints in both the pelvic limbs. Etretinate, a retinoid, was used for medical management; however, no improvement in the clinical signs was observed. Inheritance of the disorder has not yet been demonstrated. Furthermore, the clinical signs and histopathological findings of feline FOP-like condition in the present case differed from those of the previously reported cases.
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Affiliation(s)
- Kazushi Asano
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Kameino, Fujisawa, Japan
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9
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Brisse H, Orbach D, Klijanienko J, Fréneaux P, Neuenschwander S. Imaging and diagnostic strategy of soft tissue tumors in children. Eur Radiol 2006; 16:1147-64. [PMID: 16411083 DOI: 10.1007/s00330-005-0066-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2005] [Revised: 10/04/2005] [Accepted: 10/21/2005] [Indexed: 02/07/2023]
Abstract
The diagnosis of a soft tissue mass in children is a common clinical situation. Most of the lesions are benign and can be treated conservatively or by non-mutilating surgery. Nevertheless, the possibility of a malignant soft tissue tumor must be systematically considered. The most frequent benign soft tissue lesions in children are vascular lesions, fibrous and fibrohistiocytic tumors and pseudotumors, whereas rhabdomyosarcomas account for 50% of all soft tissue sarcomas. A child presenting an atypical soft tissue mass should be managed by a multidisciplinary centre, and primary resection must be proscribed until a definite diagnosis has been established. The role of imaging is essential either to confirm the benign nature of the mass or to give arguments to perform a diagnostic biopsy. Clinical examination, conventional radiography and ultrasound with Doppler represent the first-line examinations and are sometimes sufficient to assess a diagnosis. In all other situations, MRI is mandatory to establish the probable nature of the lesion and to assess local extension.
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Affiliation(s)
- Hervé Brisse
- Imaging Department, Institut Curie, 26 rue d'Ulm, 75005, Paris, France.
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10
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Herford AS, Boyne PJ. Ankylosis of the jaw in a patient with fibrodysplasia ossificans progressiva. ACTA ACUST UNITED AC 2003; 96:680-4. [PMID: 14676758 DOI: 10.1016/j.tripleo.2003.08.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A case of fibrodysplasia ossificans progressiva (FOP) is presented. This uncommon connective tissue disease tends to produce progressing ectopic osteogenesis. Because there are no reported curative procedures for TMJ ankylosis occurring in this condition, a palliative surgical approach is described. Etiology, diagnosis, and prognosis of the disease is reviewed. Recent research in BMP cytokine-induced bone repair may allow new approaches to treating this debilitating disease in the future.
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Affiliation(s)
- Alan S Herford
- Department of Oral & Maxillofacial Surgery, Loma Linda University, School of Dentistry, Calif 92350, USA.
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11
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Hagiwara H, Aida N, Machida J, Fujita K, Okuzumi S, Nishimura G. Contrast-enhanced MRI of an early preosseous lesion of fibrodysplasia ossificans progressiva in a 21-month-old boy. AJR Am J Roentgenol 2003; 181:1145-7. [PMID: 14500246 DOI: 10.2214/ajr.181.4.1811145] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Hiroaki Hagiwara
- Department of Radiology, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama 232-8555, Japan.
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12
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Singh A, Ayyalapu A, Keochekian A. Anesthetic management in fibrodysplasia ossificans progressiva (FOP): a case report. J Clin Anesth 2003; 15:211-3. [PMID: 12770658 DOI: 10.1016/s0952-8180(02)00508-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Fibrodysplasia ossificans progressiva (FOP) is a rare congenital disorder of connective tissue, which has significant implications on anesthetic management of affected patients, e.g., application of difficult airway algorithm, avoiding any trauma during venous cannulation. FOP has received very limited reviews in the published anesthesia literature. We describe perioperative care of a 21-year-old female with established diagnosis of FOP presenting for hysteroscopy followed by dilatation and curettage. Multiorgan abnormalities of FOP are reviewed and available anesthetic options are analyzed and compared.
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Affiliation(s)
- Amrik Singh
- Department of Anesthesiology, Univeristy of California (Davis) Medical Center, Sacramento, CA 95817, USA.
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13
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Debeney-Bruyerre C, Chikhani L, Lockhart R, Favre-Dauvergne E, Weschler B, Bertrand JC, Guilbert F. Myositis ossificans progressiva: five generations where the disease was exclusively limited to the maxillofacial region. A case report. Int J Oral Maxillofac Surg 1998; 27:299-302. [PMID: 9698179 DOI: 10.1016/s0901-5027(05)80619-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Myositis ossificans progressiva is an unusual autosomal-dominant inherited disease characterized by congenital malformations and osseous metaplasia of the fascia of the muscles and connective tissue leading to ossification of the relevant area. The case report is remarkable in that eight members of the same family over five generations manifested the exclusive localization of the disease in the maxillofacial region.
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Affiliation(s)
- C Debeney-Bruyerre
- Clinique et UFR de Stomatologie et de Chirurgie Maxillo-facial, Hôpital de la Salpêtrière, Paris, France.
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14
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Bridges AJ, Hsu KC, Singh A, Churchill R, Miles J. Fibrodysplasia (myositis) ossificans progressiva. Semin Arthritis Rheum 1994; 24:155-64. [PMID: 7899873 DOI: 10.1016/0049-0172(94)90071-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Fibrodysplasia ossificans progressiva (FOP) is a rare hereditary connective tissue disorder. Patients with FOP develop progressive ossification of muscle and connective tissue associated with pain and disability. Onset is typically in childhood, and congenital anomalies of the feet are an early sign of this condition. Pain and stiffness of the spine or an inflammatory mass are common presenting features of FOP. Involvement of the spine often leads to complete fusion mimicking ankylosing spondylitis. Studies of twins and families suggest that FOP is a genetically inherited autosomal dominant trait with complete penetrance but variable expressivity. While radionuclide imaging and computed tomography are very sensitive for new bone formation and greatly assist the diagnosis of FOP, unfortunately, effective therapy is unavailable. We present twins with FOP and review the clinical, radiographic, and genetic manifestations of this disorder.
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Affiliation(s)
- A J Bridges
- Department of Internal Medicine, University of Missouri Hospital and Clinics, Columbia
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15
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Shah PB, Zasloff MA, Drummond D, Kaplan FS. Spinal deformity in patients who have fibrodysplasia ossificans progressiva. J Bone Joint Surg Am 1994; 76:1442-50. [PMID: 7929490 DOI: 10.2106/00004623-199410000-00002] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We reviewed roentgenograms and clinical records in order to characterize the spinal deformity in forty patients who had an established diagnosis of fibrodysplasia ossificans progressiva. Twenty-six (65 per cent) of the patients had scoliosis, which, according to the clinical records and the recollection of the patients, had been present during childhood. Twenty-three (88 per cent) of the twenty-six curves were unbalanced c-shaped curves, while the remaining three (12 per cent) were balanced s-shaped curves. Twenty-one (91 per cent) of the twenty-three c-shaped curves involved the thoraco-lumbar or lumbar spine. The c-shaped curves ranged in magnitude from 15 to more than 80 degrees. Curves became rigid by early adulthood and many resulted in severe pelvic obliquity with impaired sitting or standing balance. An osseous bridge developed between the posterolateral aspect of the iliac crest and the posterolateral aspect of the rib cage in twenty-two (55 per cent) of the forty patients. Nineteen (86 per cent) of these twenty-two patients had scoliosis; there was a significant association between the development of scoliosis and the presence of the osseous bridge (p < 0.005). Ossification of the paravertebral muscles and fascia during the first decade of life limited the development of a normal thoracic kyphosis in ten (42 per cent) of twenty-four patients for whom lateral roentgenograms of the spine were available. A spinal orthosis was used to treat the scoliosis in two patients, but this method resulted in breakdown of the skin and failed to halt progression of the curve.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- P B Shah
- Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia
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16
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Abstract
Fibrodysplasia ossificans progressiva (FOP) is a rare, congenital disorder characterized by diffuse ossification of extraskeletal connective tissue. The classical features and progression of the disease are described and three cases are presented which fall into the general pattern of FOP clinically and radiologically. A constant feature seen was a slight metaphyseal flaring with spiking at the edges of the metaphyses, compatible with minor alteration in bone morphology during growth. These changes cannot be seen after epiphyseal fusion. The major abnormalities persist into adult life.
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Affiliation(s)
- M O'Reilly
- Royal National Orthopaedic Hospital, London, UK
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17
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Bruni L, Giammaria P, Tozzi MC, Camparcola D, Scopinaro F, Imperato C. Fibrodysplasia ossificans progressiva. An 11-year-old boy treated with a diphosphonate. ACTA PAEDIATRICA SCANDINAVICA 1990; 79:994-8. [PMID: 2124774 DOI: 10.1111/j.1651-2227.1990.tb11371.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Fibrodysplasia ossificans progressiva (FOP) is a severe, rare, autosomal dominant, ectopic ossifying condition, with primary involvement of the skeletal muscles associated with skeletal abnormalities. This report concerns an 11-year-old boy suffering from FOP, who presented significant modification of the musculoskeletal structure of the thorax and problems with articular movements. The patient showed progress after treatment with ethane-1-hydroxy-1,1-diphosphonate (EHDP). In fact, using a scintiscanner we were able to observe a significant improvement in symptoms and a recovery of some of the active sites of ossification.
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Affiliation(s)
- L Bruni
- Department of Paediatrics, University of Rome, La Sapienza, Italy
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18
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McAteer EJ, Hallam LA, Hendry GM. Ultrasonic appearances of the early changes in fibrodysplasia ossificans progressiva. Br J Radiol 1990; 63:809-12. [PMID: 2242483 DOI: 10.1259/0007-1285-63-754-809] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- E J McAteer
- Department of Radiology, Royal Hospital for Sick Children, Edinburgh
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19
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Kabala JE, Watt I, Hollingworth P, Ross JW. Trismus and multifocal soft tissue ossification. A presentation of fibrodysplasia ossificans progressiva? Clin Radiol 1989; 40:523-7. [PMID: 2507212 DOI: 10.1016/s0009-9260(89)80273-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A 21-year-old female patient presented with trismus, initially diagnosed as related to pericoronitis. Computed tomography demonstrated heterotopic soft tissue ossification involving both medial pterygoids which was later followed by similar features in the submandibular muscles and right quadriceps. A variant of fibrodysplasia ossificans progressiva was considered the likeliest diagnosis. The computed tomographic features of the condition and the importance of early diagnosis are stressed.
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Affiliation(s)
- J E Kabala
- Department of Radiodiagnosis, Bristol Royal Infirmary
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20
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Carter SR, Davies AM, Evans N, Grimer RJ. Value of bone scanning and computed tomography in fibrodysplasia ossificans progressiva. Br J Radiol 1989; 62:269-72. [PMID: 2702384 DOI: 10.1259/0007-1285-62-735-269] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- S R Carter
- Department of Radiology, Royal Orthopaedic Hospital, Birmingham
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