Myositis Ossificans - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes the condition of Myositis Ossificans. Bony formation within a muscle secondary to a blunt trauma. It could mimic osteogenic sarcoma (osteosarcoma) on x-rays and in biopsy. The condition occurs in young active males due to trauma to the muscle and soft tissues (hematoma in the muscle). The muscles that are usually involved include the quadriceps muscle, brachialis muscle, gluteal muscles and deltoid muscles.
Clinical presentation: Pain, tender swelling and decreased range of motion will usually occur within days of the injury. Painless, enlarging mass that occurs usually after an injury. It is a self-limiting problem.
X-rays: The mineralization occurs about 3 weeks after the injury. Initially you will find faint, irregular soft tissue density called dotted veil pattern. This is followed by a “zoning pattern: as the mineralization progresses. You will find that “zoning” is like an egg shell that is mineralized from new bone that appears usually after trauma. This peripheral maturation is the opposite of what you would see in malignant tumors. For example, in osteosarcoma the central part of the tumor is mature. The differential diagnosis may include extraskeletal osteosarcoma (soft tissue osteosarcoma) or periosteal osteosarcoma. CT scans of myositis ossificans will show the “egg shell” calcification.
Treatment: The patient is typically a young active male with a painless mass that occurs 2-4 weeks after injury. Treatment will include rest, activity modification, observations and physical therapy to maintain the active range of motion (no passive range of motion). Do not excise it in early stages because this will lead to recurrence. The size of the mass will usually decrease after 1 year. Follow up x-rays will be needed. If surgery is indicated, it should be delayed until the lesion is mature (may take up to one year). Some people will go early. There is a risk that the mass may return.
Fibrodysplasia Ossificans Progressiva (FOP): It is an inherited affliction, autosomal dominant pattern, in which the ossification can occur without injury, and typically grows in a predictable pattern. It also can occur from genetic mutation. It is a rare disease involving the ACVR1 gene, a BMP type1. BMP4, which helps in the formation of the skeleton in the embryo, is also implicated. The disease has progressive heterotopic ossification (muscles, fascia, tendons, ligaments and joint capsules) and congenital malformation of the great toe.

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[skeletopedia]

The rad-path correlation of fibroblastic and osteoblastic zones was very helpful. Thank you!

[fitness]

Happened to me. I will make it. Update 1 year from now if even 1 person wants to know. Cheers people :)

[Jaymz-nmzm]

Thankyou so much for this information 👍

[manofohmchemicalcreations]

I might have a couple of Transdermal cocktails for minor calcium flow disruptions in muscles... Some success with DOMS as well as post bruising pain. Probably works for MO as well as a litany of other disorders. Simple answer biological formic acid(Juniper fresh off the tree) and to a lesser extent vinegar massage. Not so simple in reality, given the need to blend in emoliants and functionally supporting ingredients. Brushing, flossing, picking, going to your dentist or better yet your periodontist could help more than anything for calcifications in your body. Modern medicine is at the doorstep of understanding the flow of calcium in and out of your body. Some of us found ourselves ahead of the curve. 10 points if you can guess why formic acid specifically.

[mohamedsamy]

لو سمحت ي دكتور أنا عندى Myositis Ossificans فعضلة الفخذ الأمامية بقالى حوالى سنة وباخود إيندوميثاسين عشان نعملها تحجر ونشيلها على أخر السنة إن شاء الله
هل في حاجه اقوى من إندوميثاسين؟ وهل كل منتأخر عليها دة بيكون أحسن

[zizodbest]

I've had this for over 3 years now. Can physical therapy make it go away, or there has to be surgery at some point. I have the pump in front of my hip. I can't tie my shoes due to the obstruction.

[worldaround]

Thanks a lot sir. I want to know why malignant tumors have calcification from center and myositis has calcification from periphery.

[zohrebrown]

can this occur all over the body in all muscles?

[nidafaruqui]

Fibrodysplasia ossificans progressiva (FOP)

[tchoopee]

Anybody else here because they got this injury from playing football