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Multimodality imaging of early heterotopic bone formation
N R Laurin1, J E Powe, W F Pavlosky
1Department of Nuclear Medicine, Victoria Hospital Corporation, University of Western Ontario, London.
Summary
Heterotopic bone formation can mimic deep vein thrombosis in paraplegic patients. Early bone scanning is a sensitive diagnostic tool, with computed tomography useful in complex cases.
Area of Science:
- Radiology
- Orthopedics
- Vascular Medicine
Background:
- Heterotopic ossification (HO) is abnormal bone growth outside of bone tissue.
- Paraplegic patients are at increased risk for complications like deep vein thrombosis (DVT).
- Atypical HO presentation can pose diagnostic challenges.
Observation:
- A young paraplegic patient presented with symptoms mimicking acute deep vein thrombosis.
- Various imaging modalities were employed for diagnosis.
- The initial presentation was atypical for heterotopic bone formation.
Findings:
- Early bone scanning demonstrated high sensitivity for diagnosing the condition.
- Computed tomography (CT) proved valuable in complex or challenging cases.
- The diagnostic utility of other imaging methods like contrast venography and MRI was limited.
Implications:
- Highlights the importance of considering heterotopic ossification in paraplegic patients with DVT-like symptoms.
- Emphasizes the diagnostic value of early bone scintigraphy.
- Suggests a tiered approach to imaging, prioritizing bone scanning and CT for difficult diagnoses.