The treatment challenge of heterotopic ossification in a patient with Parkinson's disease and stroke

Neurogenic heterotopic ossification (HO) is characterized by bone formation in a non-anatomical site. It is usually seen in patients with spinal cord injury and traumatic brain injury. It occurs less frequently in other types of acquired brain injury. Neurogenic HO has only been recorded in a few cases of Parkinson's disease (PD). Its treatment is challenging and may need pain palliation methods. The course and treatment approach of a complicated case with PD and stroke who developed HO of the hip joints during rehabilitation was discussed in this article.

A 79-year-old male patient with stroke and PD experienced restriction and pain in both hip joints. Bilateral HO was discovered on a pelvic radiograph. He did not benefit from exercises, transcutaneous electrical nerve stimulation, or indomethacin. Radiotherapy has also been tried to treat HO. Following that, obturator and femoral nerve blocks were used to relieve pain, and pain was reduced and sitting balance improved.

HO is a rare complication of PD and stroke that has an adverse effect on the rehabilitation process. Since treatment choices are limited, palliative pain management approaches such as peripheral nerve block may be considered.