What happens during heterotopic bone formation?
Heterotopic Ossification (HO) is the abnormal growth of bone in the non-skeletal tissues including muscle, tendons or other soft tissue. When HO develops, new bone grows at three times the normal rate, resulting in jagged, painful joints.
What is the cause of heterotopic ossification?
Heterotopic ossification (HO) is the presence of bone in soft tissue where bone normally does not exist. The acquired form of HO most frequently is seen with either musculoskeletal trauma, spinal cord injury, or central nervous system injury.
Who is at risk for heterotopic ossification?
Heterotopic Ossification
| Risk Factors for Heterotopic Ossification | ||
|---|---|---|
| Injury severity score (ISS) | • High ISS is a risk | 11% |
| Burns | • Both locally under burn and remotely. • More common with >20% body surface area | |
| Decubitus ulcers | • Worse with concomitant decubitus ulcers and SCI or TBI | 70% (with concomitant SCI) |
What causes bones to grow abnormally?
Fibrous dysplasia is a condition that causes abnormal growth or swelling of bone. The cause seems to be a genetic change that alters the usual growth of the bone’s connective tissue.
Where does heterotopic ossification occur?
HO occurs with the highest frequency at the elbow, followed by the shoulder, and subsequently the hip. Owing to its location around joints, those patients with burn injury–induced HO often have a restriction in the range of motion as an early manifestation of the ossification.
What are the bones sickness?
Examples of metabolic bone diseases include osteoporosis, rickets, osteomalacia, osteogenesis imperfecta, marble bone disease (osteopetrosis), Paget disease of bone, and fibrous dysplasia.
What are the signs and symptoms of heterotopic ossification?
The most common heterotopic ossification symptoma are pain around the ossification site pain and decreased range of motion (ROM). Associated features can include fever, soft tissue swelling, and poor mobility of the affected joint. Patients often complain of stiffness in their joints.
What is heterotopic bone formation and how does it occur?
In people with heterotopic bone formation, a similar process takes place, but often for an unknown reason. The process of new bone formation is called skeletogenesis. When this process occurs outside of where normal bone should exist, the result is called heterotopic ossification.
What is the relationship between elbow pain and heterotopic ossification in spasticity?
Pain, in turn, increases spasticity, completing the vicious circle. If the patient’s neurologic condition improves rapidly, the amount of heterotopic ossification is lessened, and no significant impairment may result if an adequate range of elbow motion is maintained.
What are the treatment options for heterotopic bone disease?
Certain medications, including high doses of nonsteroidal anti-inflammatory medications ( NSAIDs ), have been shown to decrease the development of heterotopic bone. Another controversial treatment is the use of radiation treatment in a single dose to alter the cells that produce the excess bone formation.