Myositis ossificans circumscripta: from diagnosis to treatment

Pauline Despontin, Nanni Allington (1) Published in the journal : May 2023 Category : Chirurgie orthopédique

Summary :

Non-tumoral heterotopic bone proliferation within soft tissues, and more specifically in striated skeletal muscles, is known as myositis ossificans.

The most frequently encountered form is the acquired form which is benign and often trauma-related, but can also appear without any trigger. It develops through three stages (acute, subacute, and mature). Diagnosis can be difficult, especially during the acute phase where the clinical presentation can mimic other pathologies, such as muscle abscess or sarcoma. It is important to identify the disease at this stage, as it avoids unnecessary recourse to biopsy. When mature, myositis ossificans has a well-defined appearance, hence the name myositis ossificans circumscripta. In all cases, the diagnosis will require imaging exams. The pathophysiological mechanism of myositis ossificans has not yet been fully elucidated, but there are several theories.

This article illustrates the diagnosis and management of acquired and circumscribed myositis ossificans on the basis of a clinical case.

What is already known about the topic?

Myositis ossificans circumscripta is a benign and well-defined lesion corresponding to a heterotopic bone formation, most often found within striated skeletal muscle tissue and following trauma. In the acute phase of the disease, the symptomatology may mimic other pathologies, which can be more severe, and the challenge is to establish the diagnosis.

What does this article bring up for us?

The aim of this article is to raise awareness about the diagnosis of myositis ossificans and to summarize the current knowledge on this subject, based on a concrete clinical case.

Key Words

Circumscribed myositis ossificans, heterotopic bone proliferation, acquired myositis ossificans