Myositis ossificans

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Pain in the left hip for one week. No history of trauma.

Patient Data

Age: 55 years
Gender: Male
x-ray

Calcific density is seen on the left projected near the hip joint. The hip joint itself is unremarkable. There is also calcific density seen on the right. 

ct

Extensive calcified material seen in the soft tissues surrounding the left hip. This extends superiorly just adjacent to the inferior portion of the ilium and inferiorly to level just below the lesser trochanter.

A further small amount of soft tissue calcification is seen adjacent to the right hip joint posteriorly. The hip joints are unremarkable. No fractures identified.

Case Discussion

The findings are characteristic of myositis ossificans (MO), which is benign metaplastic process characterized by heterotopic ossification, usually within large muscles (as in this case). 

This patient has a history of hemiplegia from a right MCA territory stroke. Paraplegics are especially prone to MO around the hips and knees, and there is often no history of trauma. 

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