pyrophosphate and Myositis-Ossificans

The radionuclide investigation of skeletal trauma in the past was confined generally to scintimetry and an occasional bone scan. The development of improved radiopharmaceuticals, including 99mTc-labeled compounds with their enhanced sensitivity, and the refinement of imaging devices offering superior resolution and speed have allowed a more detailed assessment of conditions resulting from trauma. Practical approaches to the diagnosis of subtle bone injury resulting in stress fracture, the differentiation between delayed healing and nonunion, and early recognition of avascular necrosis and osteomyelitis are now available. The changing pattern of radionuclide uptake in bone following damage by radiation and other abnormalities as a consequence of trauma also can be easily studied.

Topics: Adolescent; Adult; Athletic Injuries; Calcium Radioisotopes; Child; Diphosphates; Female; Femur Head Necrosis; Fluorine; Fractures, Bone; Fractures, Spontaneous; Fractures, Ununited; Humans; Male; Middle Aged; Myositis Ossificans; Osteomyelitis; Radiation Injuries; Radionuclide Imaging; Radiotherapy; Strontium Radioisotopes; Technetium

Although most physicians associated myositis ossificans with recent, acute trauma, only 40%-60% of patients give such a history. The appearance of a soft tissue mass without a clear history of trauma may suggest a diagnosis of sarcoma, especially because results of a biopsy of the central portion of an area of myositis ossificans may yield immature, undifferentiated tissue resembling a sarcoma. Pain and rapid growth of a mass are more usual in myositis ossificans than in sarcomas, and careful inquiry may reveal stretching injury or chronic trauma associated with normal, vigorous, physical activities. Recognizing the characteristic histologic zoning phenomenon (immature tissue centrally surrounded by more mature tissue and a peripheral shell of benign bone) during the biopsy procedure permits the correct diagnosis of myositis ossificans. Plain radiographs or conventional tomograms may reflect this histologic zoning by demonstrating the typical, mature, outer shell of bone. Although additional radiographic studies are not usually necessary, they may be obtained when the mass is suspected to be a sarcoma. In two patients computed tomographic scans clearly demonstrated well-defined, peripheral shells of mature bone, diagnostic of myositis ossificans.

Topics: Adolescent; Adult; Diphosphates; Female; Humans; Male; Myositis Ossificans; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Tomography, X-Ray; Tomography, X-Ray Computed

Topics: Adult; Diphosphates; Female; Humans; Myositis Ossificans; Radionuclide Imaging; Technetium; Thigh