Heterotopic ossification: Difference between revisions
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{{Infobox medical condition | |||
| name = Heterotopic ossification | |||
| image = [[File:Heterotopic_Ossification_Hip1.JPG|250px]] | |||
| caption = X-ray of heterotopic ossification around the hip joint | |||
| field = [[Orthopedics]] | |||
| synonyms = Ectopic bone formation | |||
| symptoms = Pain, swelling, decreased range of motion | |||
| complications = Joint stiffness, nerve compression | |||
| onset = Typically within weeks after injury or surgery | |||
| duration = Chronic | |||
| causes = [[Trauma]], [[surgery]], [[neurological injury]] | |||
| risks = [[Spinal cord injury]], [[traumatic brain injury]], [[burns]] | |||
| diagnosis = [[X-ray]], [[CT scan]], [[MRI]] | |||
| differential = [[Myositis ossificans]], [[osteosarcoma]] | |||
| prevention = [[NSAIDs]], [[radiation therapy]] | |||
| treatment = [[Physical therapy]], [[surgical excision]] | |||
| prognosis = Variable, depends on severity and treatment | |||
| frequency = Common in patients with severe trauma or neurological injury | |||
}} | |||
[[File:Heterotopic_Ossification_Elbow2.JPG|Heterotopic ossification in the elbow|thumb|left]] | |||
[[File:Heterotopic_Ossification_removal_2011.jpg|Heterotopic ossification removal surgery|thumb]] | |||
[[File:Heterotopic_Ossification_Elbow_RT.JPG|Heterotopic ossification in the elbow|thumb|left]] | |||
'''Heterotopic Ossification''' (HO) is a pathological process characterized by the abnormal formation of mature, lamellar bone in non-osseous tissues. This condition often occurs after traumatic injuries or surgeries and can lead to significant complications such as pain, joint contractures, and loss of range of motion. | '''Heterotopic Ossification''' (HO) is a pathological process characterized by the abnormal formation of mature, lamellar bone in non-osseous tissues. This condition often occurs after traumatic injuries or surgeries and can lead to significant complications such as pain, joint contractures, and loss of range of motion. | ||
==Etiology== | ==Etiology== | ||
The exact cause of [[Heterotopic Ossification]] is not fully understood. However, it is believed to be triggered by an inflammatory response to tissue injury. This can occur following trauma, burns, central nervous system injuries, or orthopedic surgeries. Certain genetic conditions, such as [[Fibrodysplasia ossificans progressiva]], are also associated with HO. | The exact cause of [[Heterotopic Ossification]] is not fully understood. However, it is believed to be triggered by an inflammatory response to tissue injury. This can occur following trauma, burns, central nervous system injuries, or orthopedic surgeries. Certain genetic conditions, such as [[Fibrodysplasia ossificans progressiva]], are also associated with HO. | ||
==Pathophysiology== | ==Pathophysiology== | ||
In [[Heterotopic Ossification]], there is an aberrant differentiation of mesenchymal stem cells into osteoblastic lineage cells, leading to bone formation in soft tissues. This process is regulated by various growth factors and cytokines, including bone morphogenetic proteins (BMPs), transforming growth factor-beta (TGF-beta), and others. | In [[Heterotopic Ossification]], there is an aberrant differentiation of mesenchymal stem cells into osteoblastic lineage cells, leading to bone formation in soft tissues. This process is regulated by various growth factors and cytokines, including bone morphogenetic proteins (BMPs), transforming growth factor-beta (TGF-beta), and others. | ||
==Clinical Presentation== | ==Clinical Presentation== | ||
Patients with HO may present with pain, swelling, warmth, and decreased range of motion in the affected area. The symptoms usually appear several weeks after the inciting event. In severe cases, HO can lead to joint ankylosis and significant functional impairment. | Patients with HO may present with pain, swelling, warmth, and decreased range of motion in the affected area. The symptoms usually appear several weeks after the inciting event. In severe cases, HO can lead to joint ankylosis and significant functional impairment. | ||
==Diagnosis== | ==Diagnosis== | ||
The diagnosis of HO is typically made based on clinical findings and imaging studies. Radiographs can show the presence of ectopic bone, but they may not be positive until 2-6 weeks after symptom onset. Computed tomography (CT) and magnetic resonance imaging (MRI) can detect HO earlier than radiographs. | The diagnosis of HO is typically made based on clinical findings and imaging studies. Radiographs can show the presence of ectopic bone, but they may not be positive until 2-6 weeks after symptom onset. Computed tomography (CT) and magnetic resonance imaging (MRI) can detect HO earlier than radiographs. | ||
==Treatment== | ==Treatment== | ||
The treatment of HO includes conservative measures such as physical therapy and nonsteroidal anti-inflammatory drugs (NSAIDs). In cases where HO causes significant functional impairment, surgical excision of the ectopic bone may be necessary. However, there is a high risk of recurrence after surgery. Pharmacological prophylaxis with NSAIDs or bisphosphonates is often used to prevent HO after high-risk surgeries. | The treatment of HO includes conservative measures such as physical therapy and nonsteroidal anti-inflammatory drugs (NSAIDs). In cases where HO causes significant functional impairment, surgical excision of the ectopic bone may be necessary. However, there is a high risk of recurrence after surgery. Pharmacological prophylaxis with NSAIDs or bisphosphonates is often used to prevent HO after high-risk surgeries. | ||
==Prognosis== | ==Prognosis== | ||
The prognosis of HO depends on the severity of the condition and the patient's overall health status. With appropriate treatment, many patients can achieve good functional outcomes. However, HO can cause significant morbidity in severe cases. | The prognosis of HO depends on the severity of the condition and the patient's overall health status. With appropriate treatment, many patients can achieve good functional outcomes. However, HO can cause significant morbidity in severe cases. | ||
==See Also== | ==See Also== | ||
* [[Fibrodysplasia ossificans progressiva]] | * [[Fibrodysplasia ossificans progressiva]] | ||
* [[Bone morphogenetic proteins]] | * [[Bone morphogenetic proteins]] | ||
* [[Nonsteroidal anti-inflammatory drugs]] | * [[Nonsteroidal anti-inflammatory drugs]] | ||
[[Category:Orthopedic disorders]] | [[Category:Orthopedic disorders]] | ||
[[Category:Pathology]] | [[Category:Pathology]] | ||
[[Category:Rheumatology]] | [[Category:Rheumatology]] | ||
{{Medicine-stub}} | {{Medicine-stub}} | ||
Latest revision as of 23:58, 9 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Heterotopic ossification | |
|---|---|
| |
| Synonyms | Ectopic bone formation |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Pain, swelling, decreased range of motion |
| Complications | Joint stiffness, nerve compression |
| Onset | Typically within weeks after injury or surgery |
| Duration | Chronic |
| Types | N/A |
| Causes | Trauma, surgery, neurological injury |
| Risks | Spinal cord injury, traumatic brain injury, burns |
| Diagnosis | X-ray, CT scan, MRI |
| Differential diagnosis | Myositis ossificans, osteosarcoma |
| Prevention | NSAIDs, radiation therapy |
| Treatment | Physical therapy, surgical excision |
| Medication | N/A |
| Prognosis | Variable, depends on severity and treatment |
| Frequency | Common in patients with severe trauma or neurological injury |
| Deaths | N/A |
Heterotopic Ossification (HO) is a pathological process characterized by the abnormal formation of mature, lamellar bone in non-osseous tissues. This condition often occurs after traumatic injuries or surgeries and can lead to significant complications such as pain, joint contractures, and loss of range of motion.
Etiology[edit]
The exact cause of Heterotopic Ossification is not fully understood. However, it is believed to be triggered by an inflammatory response to tissue injury. This can occur following trauma, burns, central nervous system injuries, or orthopedic surgeries. Certain genetic conditions, such as Fibrodysplasia ossificans progressiva, are also associated with HO.
Pathophysiology[edit]
In Heterotopic Ossification, there is an aberrant differentiation of mesenchymal stem cells into osteoblastic lineage cells, leading to bone formation in soft tissues. This process is regulated by various growth factors and cytokines, including bone morphogenetic proteins (BMPs), transforming growth factor-beta (TGF-beta), and others.
Clinical Presentation[edit]
Patients with HO may present with pain, swelling, warmth, and decreased range of motion in the affected area. The symptoms usually appear several weeks after the inciting event. In severe cases, HO can lead to joint ankylosis and significant functional impairment.
Diagnosis[edit]
The diagnosis of HO is typically made based on clinical findings and imaging studies. Radiographs can show the presence of ectopic bone, but they may not be positive until 2-6 weeks after symptom onset. Computed tomography (CT) and magnetic resonance imaging (MRI) can detect HO earlier than radiographs.
Treatment[edit]
The treatment of HO includes conservative measures such as physical therapy and nonsteroidal anti-inflammatory drugs (NSAIDs). In cases where HO causes significant functional impairment, surgical excision of the ectopic bone may be necessary. However, there is a high risk of recurrence after surgery. Pharmacological prophylaxis with NSAIDs or bisphosphonates is often used to prevent HO after high-risk surgeries.
Prognosis[edit]
The prognosis of HO depends on the severity of the condition and the patient's overall health status. With appropriate treatment, many patients can achieve good functional outcomes. However, HO can cause significant morbidity in severe cases.
See Also[edit]
- Fibrodysplasia ossificans progressiva
- Bone morphogenetic proteins
- Nonsteroidal anti-inflammatory drugs
