Wednesday, June 1, 2011

Heterotopic ossification - ectopic (myositis ossificans) - Diagnosis

Laboratory studies:Creatine kinase-testing is not specific for heterotopic ossification but is valuable for determining the severity of muscle damage and treatment plamificareaC-reactive protein is increased in the initial stage of disease when there is an active inflammatory response-Osteocalcin is a marker of activity osteoblaastice-Nonspecific alkaline phosphatase is high because it is associated with surgery and injuries and disorders.
Imaging Studies:Bone scintigraphy is recommended for early diagnosis of heterotopic ossification because nemineralizate still detect ossification.Ultrasound is also used for early diagnosis of ossification of the balance.Radiography in diagnosis is typical heterotopic ossification, but is not sensitive in early diagnosis. Since calcifications detected by X-ray soft tesututlui only metabolic maturity. The study identifies lesions that spots that merge and increase in subsequent examinations, and in three months to identify mature bone. It takes two weeks before the lesions mjineralizarea enough to be detectable on radiography.CT scanning detects early condition. Bone scan shows abnormal vascularization of the lesion. Hipervaacularizatia can be seen in angiography. When mature heterotopic ossification angiography is not useful because they are avascular.Histological examination: a week of fibroblast proliferation appears TRUMA. A few days after the proliferation of peripheral primitive osteoid develops. Two weeks after trauma develop primitive cartilage. Trabecular bone begins to develop 2-5 weeks after trauma. If biopsy is performed at 6 weeks after trauma center immature undifferentiated tissue is observed with peripheral mature lamellar bone.The differential diagnosis is made with the following conditions: cellulitis, osteomyelitis, thrombophlebitis, fractures, hematoma, local trauma.

No comments:

Post a Comment