Myositis ossificans in hemophilia

Vas, Wenzel; Cockshott, W. Peter; Martin, Robert F.; Pai, Mohan; Walker, Irwin

doi:10.1007/bf00347168

Cited by 27 publications

(10 citation statements)

References 9 publications

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“…We do not have reliable epidemiological data on its precise incidence, localization and natural history. One report showed a spontaneous resolution of the new bone formation [10] and another report suggested a negligible disability with this condition [11]. Our patient received a physical therapy programme for 6 months.…”

Section: Discussionmentioning

confidence: 84%

Iliopsoas haemorrhage in patients with haemophilia: results from one centre

2005

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Iliopsoas haematoma is a well-recognized complication of haemophilia, and is considered as potentially life threatening and significantly associated with morbidity. There are only rare reports on the incidence or outcomes of iliopsoas bleeding since the widespread usage of modern therapies for haemophilia. In this study, we present the experience of Ege University Haemophilia Centre with iliopsoas bleeding and its early and late complications. We reviewed 146 haemophiliacs (106 haemophilia A, 40 haemophilia B). Fourteen iliopsoas bleeding episodes were identified in eight haemophiliacs. Three patients (37%) had one episode, four (50%) had two episodes and one (13%) had three episodes. Two patients had a high titre inhibitor against factor VIII and accounted for three bleeding episodes (21%). We did not observe any episodes in six patients receiving prophylaxis. Iliopsoas haematomas were confirmed by ultrasonography in all patients. In physical examination, the most common symptoms were thigh, hip and groin pain, hip flexion contracture, abdominal tenderness and paraesthesia in the distribution of the femoral nerve. The mean duration of therapy with clotting factor concentrate was 7.8 +/- 1.6 days. The mean duration of hospitalization was 4.8 +/- 2.0 days. All patients started to receive a physical therapy program 6.0 +/- 2.4 days after the initiation of haemostatic therapy which lasted 20.0 +/- 6.0 days. Ultrasonographic findings related to iliopsoas haematoma disappeared in all patients within 3 months from the initial episodes. Only in one patient with mild haemophilia A, heterotopic bone formation (myositis ossificans) developed as a long-term complication. In conclusion, pain around the hip joint, femoral neuropathy and hip flexion contracture in a patient with haemophilia should alert the physician to the possibility of an iliopsoas haematoma. Early and effective factor replacement therapy is essential in the prevention of the complications.

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Section: Discussionmentioning

confidence: 84%

Iliopsoas haemorrhage in patients with haemophilia: results from one centre

2005

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“…As the acquired form of heterotopic ossification is most frequently provoked by trauma (Vanden Bossche and Vanderstraeten 2005), bleeding might be an important precipitating factor (Vas et al 1981) and appears to have initiated the process in our case. It is important to note that heterotopic bone formation and dystrophic soft tissue calcification or calcinosis are fundamentally different.…”

Section: Discussionmentioning

confidence: 61%

Regression of heterotopic ossification after starting warfarin—an effect mediated by inhibition of γ-carboxylation of osteocalcin?—a case report

Valleala¹,

Böhling²,

Konttinen³

2007

Acta Orthopaedica

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“…11,12 Characteristics of MO found in patients with hemophilia were reported to be the same as that found in nonhemophilia patients, 11 although multiple lesions of MO are occasionally found in these situations. 12 It is considered that an initial trauma to the area and hematoma formation with fibroblastic reaction and subsequent osseus and cartilageous metaplasia plays a role to a certain degree. 1 In the present case, we could demonstrate hemosiderine positive cells in the tumor, suggesting preceding hemorrhage.…”

Section: Discussionmentioning

confidence: 83%

Myositis Ossificans Associated With Subclinical Idiopathic Thrombocytopenic Purpura: Report of a Case

et al. 2008

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A 56-year-old healthy man noticed a stony-hard mass gradually grown in his neck for more than a 6-year period. Examinations revealed 2 additional calcified masses at the esophageal hiatus and retroperitoneum. The cut-surface of the operative specimens showed fibrous and mucinous appearance with many calcified islands. Microscopically, the lesion showed a gradual transform from the central immature area with fibroblasts and mucinous matrix, to the peripheral mature area with woven bone and osteoclasts (zoning phenomenon), which was compatible with the features of mature myositis ossificans. Myositis ossificans is an isolated, benign, nonneoplastic disease typically found in adolescence, after traumatic episode. Similar lesions have been found in the major musculature of patients with increased bleeding tendency. In the present case, idiopathic thrombocytopenic purpura was found to be associated and was suggested to be involved in initiating myositis ossificans. Still, it is extremely rare to observe lesions in these sites synchronously.

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Myositis ossificans in hemophilia

Cited by 27 publications

References 9 publications

Iliopsoas haemorrhage in patients with haemophilia: results from one centre

Iliopsoas haemorrhage in patients with haemophilia: results from one centre

Regression of heterotopic ossification after starting warfarin—an effect mediated by inhibition of γ-carboxylation of osteocalcin?—a case report

Myositis Ossificans Associated With Subclinical Idiopathic Thrombocytopenic Purpura: Report of a Case

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