What Is Myositis Ossificans?

Ossifying myositis is a disease of muscle sclerosis caused by the deposition of progressive bone structure in muscle and connective tissue. The cause is unclear. Some are autosomal dominant. Common in children or youth. Appears as abnormal congenital torticollis, torsion and swelling and hardening of neck muscles, but most of them without pain. All muscles can be involved. Vigorous exercise or trauma can cause muscle rupture, hemorrhage, and hematoma formation. Secondary muscle stiffness and ossification can result in stiffness and disability of the corresponding joints of affected muscles.

Basic Information

English name

myositisossificans

Visiting department

orthopedics

Multiple groups

Children, youth

Common symptoms

Torticollis, torsion, swelling and stiffness of neck muscles

Causes of ossifying myositis

This disease is a disease of muscular sclerosis caused by the progressive deposition of bone structure in muscle and connective tissue. The cause is unclear. Some are autosomal dominant. Some scholars have reported that there are four factors that cause ossification: Stimulation factors Contusion leads to hematoma. This damage can be minor, with only a small amount of skeletal muscle or myofibrils being damaged. Damage signal The damaged tissue or cell secretes a signal protein. Mesenchymal cells with defective gene expression These cells can generate bone-like or cartilage-like cells after receiving appropriate signals. There is an environment in which ossification occurs continuously. Among them, the signal gene is the most critical.

Clinical manifestations of ossifying myositis

The disease is common in children or young people. Presented with strange congenital torticollis, torsion, and swelling and hardening of neck muscles. All muscles can be involved. According to clinical characteristics, the disease can be divided into stage :

Reaction period

Masses grow quickly, calcifications quickly, and swellings quickly. Trauma is 1 to 2 months and can reach 4 to 10 cm.

2. Active period

The active phase can be characterized by fever, high local skin temperature, tenderness, and hard masses.

3. Maturity period

Shell-shaped osteochondrosis appears in the mature period, and the growth stops during the recovery period. The hard mass usually becomes smaller after 1 year, and even disappears completely. It is self-limiting

4. Recovery period.

Ossifying myositis examination

X-ray examination is characterized by a localized mass that may appear shortly after the injury. Three to four weeks after the injury, a dense hairy image is displayed in the mass, and the adjacent bone will show a periosteal response. Six to eight weeks after the injury, the margin of the lesion was clearly surrounded by dense bone and had the appearance of new bone. The core of a soft tissue mass is sometimes cystic and gradually enlarges its lumen, and in the later stages, eggshell-like cysts appear. The mass contracted 5 to 6 months after the injury, so X-ray translucent bands appeared between the mass and the adjacent cortical and periosteum responses.

Ossifying myositis diagnosis

Diagnosis can be made based on the cause, clinical manifestations, and laboratory tests.

Ossifying myositis treatment

1. Early (reaction period)

Taking elbow ossifying myositis as an example, the forearm flexors, biceps, and triceps are gently relieved by touching, touching, rubbing, pushing, popping, and dialing at the elbow joint. Peel the adhesions of the tendons, aponeurosis, and muscles. After that, the surgeon held the wrist of the affected limb and the upper and middle part of the elbow joint, and continued to traction slightly, and then gently held the wrist of the affected limb to do the adduction, abduction and anterior and posterior flexion and ring of the elbow joint without pain. Turn around. During the manual treatment, the patient was also instructed to perform active exercise of the elbow joint without pain or slight pain.

2. Medium term (active period)

The affected limb can be massaged in accordance with early techniques. Then, the surgeon holds the proximal part of the elbow of the affected limb and the middle part of the forearm of the affected limb. The elbow is flexed and extended passively and gently, and the ossifying myositis rupture and adhesion tear are often heard. At this time, the elbow joint Passive activities can reach the basic normal range. In case of osseous obstruction, passive flexion and extension should not be forced to avoid recurrence of fracture. Surgical treatment should be performed after the ossified tissue gradually matures and is limited. After manual treatment, the patient is instructed to perform functional exercises with active movements as the mainstay and passive movements as the supplements when the pain is tolerable.

3. Late stage (ossification phase)

Surgical resection of ossified tissue and joint lysis were performed. Using a lateral elbow incision, the humerus lateral condyle is stripped to the front and back of the elbow respectively. After exposing the ossified tissue, it is removed and the adhesive tissue is completely loosened. Before closing the incision, the tourniquet should be loosened to stop bleeding and placed under pressure for drainage. After 3 weeks of braking, active joint activities were performed to prevent adhesions.