IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Heterotopic ossification reverse shoulder prosthesis

Case contributed by Domenico Nicoletti
Diagnosis almost certain

Presentation

Functional limitation of the shoulder in abduction and intra-rotation.

Patient Data

Age: 75 years
Gender: Female

Rt shoulder XR baseline

x-ray

Normal post-operative findings of reverse total shoulder arthroplasty.

Rt shoulder XR 3 yr later

x-ray

Gross heterotopic ossification located cranially to the prosthesis.
Another ossification is found in the axillary recess.

There are also new radiolucent lines at the level of the stem of the humeral component (thickness greater than 3 mm) and at the base of glenosphere, consistent with prosthesis instability.

New radiolucent lines at the level of the stem of the humeral component (thickness greater than 3 mm) and at the base of glenosphere, consistent with prosthesis instability.

Case Discussion

Heterotopic ossifications are due to bone metaplasia in the soft tissues.
  
Heterotopic ossifications can occur as a result of central nervous system lesions (traumatic brain injuries and spinal injuries), following surgical operations (prosthesis), or direct traumatic events.

They mainly develop on muscles, tendons, ligaments, and fascia, while they rarely affect the skin and organs.

Timing may be weeks or months after prosthetic surgery. Depending on the size of the calcification outbreaks they can cause pain or limit the mobility of the joint.

Case courtesy of Dr.ssa Sara Zanzani

 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.