myositis ossificans
Introduction
Introduction to ossifying myositis Myositisossificans is a disease of muscle hardening, toe, and hallar deformity caused by deposition of progressive bone structure in muscle and connective tissue, and the cause is unclear. Part of it is autosomal dominant. Common in children or young people, manifested as a congenital congenital torticollis, torsion and neck muscles that swell and harden, but most do not have pain. Muscles can be involved in the whole body. Strenuous exercise or trauma can cause muscle rupture, hemorrhage and hematoma formation, most patients with hematoma absorption, but also secondary muscle stiffness and ossification, and eventually cause the joint muscles of the affected muscles to be stiff and disabled. basic knowledge The proportion of sickness: 0.01%-0.05% Susceptible people: common in children or youth Mode of infection: non-infectious Complications: polymyositis
Cause
Causes of ossifying myositis
The disease is a progressive bone structure in the muscle, connective tissue deposition caused by muscle sclerosis, toe, abrupt deformity of a disease, the cause is unclear, part of the autosomal dominant inheritance, some scholars reported ossification There are four factors:
Trauma factor (35%)
Often contusions account for 60% to 70%, which can lead to hematoma, which can be mild, with only a small amount of skeletal muscle or myofibrils being damaged. Damaged tissue secretes a signal protein for the cell.
Congenital factors (25%)
There are mesenchymal cells with defective gene expression, and these cells can generate bone-like or cartilage-like cells after receiving appropriate signals. There is a continuous environment of ossified tissue, in which the signal gene is the most critical, and Urist named the gene BMP.
Prevention
Osteomyositis prevention
This disease is a complication of severe trauma. It can be prevented from happening and developing through hard work. Patients with joint dislocation and severe trauma should consult an orthopaedic surgeon promptly, do not blindly massage, massage causes secondary injury, joint dislocation should be timely Reset, if there is a large hematoma, it is necessary to puncture and take out the pressure dressing in time. The joint trauma should be braked early. It should be fixed in the functional position with plaster cast. If there is swelling, it should be combined with traditional Chinese and western medicine, so that the swelling will quickly disappear, and the spinal cord injury will cause paraplegia. Patients, if the lower extremity has a large hematoma of unknown origin, should be puncture and pressure bandage in time, these are effective ways to prevent secondary ossifying myositis after severe trauma.
Complication
Osteomyositis complications Complications polymyositis
This disease can cause muscle rupture, hemorrhage and hematoma formation due to strenuous exercise or trauma. Most patients have hematoma absorption, but can also develop muscle stiffness and ossification, and eventually cause joint stiffness and disability in the affected muscles. Malignant, its invasive features include muscle capsule, bone, neurovascular bundle invasion, peripheral or distant metastasis.
Symptom
Ossifying myositis symptoms common symptoms joint stiffness neck muscle swelling hard neck muscles spasm
The disease is common in children or young people. It is characterized by a congenital torticollis, a torsion and neck muscle swelling and hardening, but most of them are not accompanied by pain, and the whole body muscles can be involved. According to the clinical characteristics, the disease can be used. Divided into phase IV:
1. Reaction period: The mass increases rapidly, the calcification is fast, the swelling is rapid, and the trauma is 1 to 2 months, which can reach 4 to 10 cm.
2, active period: active period can be expressed as fever, local skin temperature is high, tenderness, hard mass.
3, maturity: shell-shaped osteochondral carcinogenesis at maturity, stop growth during the recovery period, often after 1 year, the hard mass becomes smaller, and even disappears completely, with self-limiting.
4. Recovery period.
Examine
Examination of ossifying myositis
The auxiliary examination method for this disease is mainly X-ray examination:
X-ray examination is characterized by a localized swelling soon after the injury, 3-4 weeks after the injury, showing a hairy dense image in the swollen, near the bone will show periosteal reaction, 6-8 weeks after injury, the edge of the lesion The part is clearly surrounded by dense bone, and has the appearance of new bone. The core of the soft tissue mass sometimes becomes cystic and gradually enlarges its lumen. In the late stage, it shows an eggshell-like cyst. The tumor contracted at 6 months, and the x-ray translucent band was observed between the mass and the adjacent cortical and periosteal reactions.
Diagnosis
Diagnosis and differentiation of ossifying myositis
Differential diagnosis
The disease is similar to osteoarthritis such as synovial chondroma in the advanced stage, progressive ossifying myositis, and soft tissue calcareous deposit after paraplegia. Therefore, it is easy to be misdiagnosed as ossifying tumor in the later stage.
1 joint, synovial chondroma, etc., X-ray plain film is very valuable, such as the appearance of circular or curved calcification of cartilage tumors to help qualitative diagnosis, and the more calcification, the more uniform distribution, indicating the better differentiation.
2 progressive ossifying myositis: hereditary, from a small onset, other parts such as neck, shoulders, buttocks, new stoves, old stoves alternately appear, poor prognosis, and more than breathing difficulties.
3 soft tissue calcareous deposition after paraplegia: clear history, often paraplegia or burns 6 months after long-term bed rest, blood stasis caused by vascular calcification.
