RESUMEN
Myositis ossificans circumscripta (MOC) is a rare benign disorder characterized by heterotopic ossification of soft tissues. We report a case in a 21-year-old male who presented with knee pain after strenuous physical activity. Evidence of inflammation of the knee and a hard swelling in the subquadricipital area were the main physical findings. The initial plain radiographs showed a subpatellar soft tissue mass containing flocculent calcifications. Over the next 2 months, the calcific deposits organized into a calcified mass. Magnetic resonance imaging findings were nonspecific, with a mass within the vastus medialis muscle generating low signal on T1 images and high signal on T2 images, without postgadolinium enhancement. Computed tomography showed several calcific deposits arranged in a ring, strongly suggesting MOC. Histological examination of a biopsy specimen confirmed this diagnosis. Alendronate therapy given for 6 months was followed by marked clinical improvement, obviating the need for surgery.
Asunto(s)
Alendronato/administración & dosificación , Articulación de la Rodilla/patología , Miositis Osificante/diagnóstico , Miositis Osificante/tratamiento farmacológico , Adulto , Esquema de Medicación , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Dimensión del Dolor , Pronóstico , Rango del Movimiento Articular/fisiología , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
INTRODUCTION: Hypertrophic osteoarthropathy (HOA) is a syndrome associating hippocratic fingers, arthropathy and periostosis of long bones. Currarino's disease, considered at present as a clinical form of primary HOA, is characterized by the absence of pachydermia. OBSERVATION: A 24-year-old Caucasian man, consulted for a painful swelling of both ankles that had developed over the past year. Clinical examination revealed hippocratic fingers without pachydermia. The ankles were swollen. The X-rays showed periosteal apposition and an acro-osteolysis. In view of this triad: arthropathy, hippocratic fingers and periostosis, primary HOA without cutaneous involvement or Currarino's disease was diagnosed. The search for a secondary cause remained negative. Clinical improvement was obtained after 15 months with non-steroidal anti-inflammatory drugs (NSAID) and colchicine. COMMENTS: Although exceptional, primary HOA without cutaneous involvement is a genetic disease which must not be ignored.