Heterotopic ossification (post amputation)
The patient suffered a spinal cord injury as well as traumatic injuries to the lower extremity. The lower extremity injuries were complicated by ischemia and gangrene and amputation was performed. The patient presents as an outpatient for routine check up.
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Soft tissue calcification around the femoral diaphysis amptuation margin. The trabecular pattern of the heterotopic calcification indicates that it is heterotopic ossification.
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Heterotopic ossification (HO) around amputations is a problem for doctors as long as soldiers have received amputations for battle injuries.
The pathophysiology of heterotopic ossification is not completely understood, but it is thought that it gets its start when osteogenic precursor cells are activated in the soft tissues due to changes in the local tissue environment.
The prevalence of heterotopic ossification after lower limb amputation has been estimated to be between 23-64%.
- 1. Edwards DS, Clasper JC. Heterotopic ossification: a systematic review. J R Army Med Corps. . doi:10.1136/jramc-2014-000277 - Pubmed citation
- 2. Matsumoto ME, Khan M, Jayabalan P et-al. Heterotopic ossification in civilians with lower limb amputations. Arch Phys Med Rehabil. 2014;95 (9): 1710-3. doi:10.1016/j.apmr.2014.03.010 - Pubmed citation