Presentation
Lower limb pain and swelling many years after trauma.
Patient Data
MRI of the lower extremity contrast enhanced
Multiple large sharply delineated lesions in the lower limb with mainly peripheral calcifications, consistent with late phase myositis ossificans. There is no edema or reaction in the surrounding tissues. Note the healed fracture in the proximal tibia and fibula.
CT is more suitable than MR for demonstrating the calcifications. The healed fractures in proximal tibia and fibula are also more easily appreciable, as is the old medullary osteosynthesis pathway in the tibia. Note the diffusely dense contents of the most ventral lesion: ´milk of calcium´ appearance.
Case Discussion
60 year old male referred to orthopedic surgeon with painful lower limb with multiple swellings after a crural fracture and compartment syndrome decompression in the distant past. The soft tissue calcifications seen on this CT and MRI can be adequately explained by the history of trauma and are congruent with a diagnosis of myositis ossificans.
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