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Myositis ossificans progressiva mimicking ankylosing spondylitis: a case report
L Y Lu1, H H Cheng, J C Chuang
1Department of Internal Medicine, Veterans General Hospital-Kaohsiung, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|May 1, 1992
Summary
Myositis ossificans progressiva is a rare condition causing bone formation in muscles. This case highlights its varied presentation and response to prednisolone treatment for painful masses.
Area of Science:
- Orthopedics
- Rheumatology
- Medical Genetics
Background:
- Myositis ossificans progressiva (MOP) is a rare genetic disorder characterized by progressive heterotopic ossification of skeletal muscles and connective tissues.
- While often associated with trauma, a significant percentage of MOP cases lack a clear injury history, complicating early diagnosis.
- The condition typically manifests in young adulthood, leading to significant morbidity due to progressive ossification and joint contractures.
Observation:
- A young female patient presented with a rapidly growing, painful shoulder mass, kyphosis, and spinal ankylosis.
- Initial biopsy for the shoulder mass revealed recurrent ossification, which subsequently affected the biceps muscle, causing shoulder and elbow joint deformities.
- Radiographic findings suggested ankylosing spondylitis, but the definitive diagnosis was confirmed by pathognomonic ectopic ossification in muscles and soft tissues.
Findings:
- The patient experienced recurrent ossification after an excisional biopsy, leading to progressive joint contractures.
- Despite the lack of response in established contractures, the painful ectopic ossification mass showed significant improvement in size and consistency with prednisolone treatment within two months.
Implications:
- This case underscores the importance of considering MOP in young adults with unexplained rapidly ossifying masses, even without a history of trauma.
- Early diagnosis and management are crucial to mitigate the progressive nature of heterotopic ossification and prevent severe joint deformities.
- Prednisolone may be an effective treatment option for managing the painful inflammatory component of myositis ossificans progressiva, particularly for acute ossifying masses.