Extensive heterotopic ossification in patient with tubercular meningitis

Sharma, Vineet; Yadav, Ganesh; Gupta, Anil Kumar; Kumar, Dileep

doi:10.4103/0976-3147.145211

Cited by 5 publications

(5 citation statements)

References 12 publications

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“…Nevertheless, based on the combination of biological and epidemiological evidence, Yadav and collaborators suggest that leprosy cannot be eliminated only through MDT, given that the disease’s microbiology is not yet totally understood [2]. New forms of control and detection are needed to combat transmission more directly.…”

Section: Discussionmentioning

confidence: 99%

“…Between 1 and 2 million people worldwide are currently estimated to have deformities and disabilities resulting from leprosy and it continues to be one of the main causes of neuropathy and disabilities among communicable diseases [2]. …”

Section: Introductionmentioning

confidence: 99%

“…Use of leprosy prevalence as an indicator has been criticized since it is influenced by factors such as treatment duration and case identification. Alternative indicators for monitoring the disease have been suggested, such as the rate of new cases with grade 2 disability [2, 7]. …”

Section: Introductionmentioning

confidence: 99%

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Trends of main indicators of leprosy in Brazilian municipalities with high risk of leprosy transmission, 2001–2012

2016

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BackgroundLeprosy incidence has reduced in recent years in Brazil, although the disease still persists as a public health problem in some regions. To investigate the trends of selected leprosy indicators in Brazilian municipalities with high risk of transmission is essential to provide effective control of the disease, yet this area has not been investigated.MethodsThis is an ecological time-series study with multiple groups using Notifiable Diseases Information System (SINAN) data. All 692 municipalities of the states of Mato Grosso, Tocantins, Rondônia, Pará and Maranhão were included. The incidence rates of leprosy were calculated, as well as incidence rates in children under 15 years per 100,000 inhabitants and rates of new cases presenting grade-2 disabilities per 100,000 inhabitants. Joinpoint Regression was used to analyse the time trends of the different indicators studied. The spatial distribution of temporal variations of the indicators in the period was presented.ResultsBetween 2001 and 2012, 176,929 leprosy cases were notified in the area studied, this being equivalent to 34.6 % of total cases in Brazil. In the aggregate of municipalities, there was a reduction in incidence rate of leprosy from 89.10 to 56.98 new cases per 100,000 inhabitants between 2001 and 2012, with a significant reduction between 2003 and 2012 (APC: − 6.2 %, 95 % CI: −7.2 % to −5.2 %). The incidence rate in <15 years also reduced significantly between 2003 and 2012 (APC: −5.6 %; 95 % CI: −7.2 % to −4.1 %). The rate of new cases with grade 2 disability remained stable between 2001 and 2012 (APC: −1.3 %; 95 % CI: −2.6 % to 0.1 %).ConclusionDespite the reduction in the leprosy incidence rate, strategies for controlling this disease need to be enhanced to enable early case detection, especially in hyperendemic municipalities, in order to prevent disability.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Trends of main indicators of leprosy in Brazilian municipalities with high risk of leprosy transmission, 2001–2012

2016

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“…Unlike previous reports of heterotopic ossifications in the literature, this patient with extensive heterotopic ossifications neither have neurological deficits, prolonged immobilization, fibrodysplasia ossificans progressiva nor burns [2][3][4][5][6][7][8]. This patient had multiple episodes of traumatic injury due to fights.…”

Section: Discussionmentioning

confidence: 81%

Extensive Heterotopic Ossification of Bilateral Hip and Knee Joints in a Patient with Recurrent Traumatic Injuries

Yan¹,

Wang²,

Kwong³

et al. 2021

SCR

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Background: Heterotopic ossification (HO) refers to the growth of lamellar bone in soft tissues. Extensive heterotopic ossification is rarely seen. In this case, we illustrate a 35-year-old civilian patient with extensive HO due to recurrent traumatic injuries with no neurological deficit. Case Presentation: A 35-year-old man, with a history of recurrent trauma episodes in the past year, presented with pain and swellings in bilateral lower limbs. Physical examination showed stiffness and deformities of bilateral hip and knee joints. Plain x-ray showed patchy ossification extending from hip joints to knee joints bilaterally. 3-dimensional Computer Tomography (3D-CT) showed extensive heterotopic ossifications along gluteal muscles, quadratus muscles and the deep fascia beneath, confirming the diagnosis of extensive heterotopic ossifications of bilateral hip and knee joints. Excision of ossified tissues and re-mobilization of iliotibial bands were performed. Early recovery after surgery (ERAS) strategy was used to speed up recovery. Conclusion: i) Extensive heterotopic ossification in civilian patients is possible. Clinical history should be reviewed to rule out recurrent traumatic injury. Surgery should be considered. ii) Three-dimensional Computer Tomography (3D-CT) is a viable tool for surgical planning to show the extent, site, and anatomical relationship with adjacent tissues. iii) Post-op early recovery after surgery (ERAS) should be considered for better clinical outcomes.

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“…7,11 HO of the shoulder is rare, even in the setting of arthroscopic surgery 7 ; when present, it is typically asymptomatic and not clinically significant. 11 To the best of our knowledge, 26 cases of nontraumatic HO of the shoulder have been described in English literature: nine infectious, [12][13][14][15][16][17][18][19] six genetic, [20][21][22][23][24][25] six neurologic, [26][27][28][29][30][31] three autoimmune, [32][33][34] one druginduced, 35 and one idiopathic. Although the etiology of HO is diverse, the pathophysiology is thought to be the same across all subtypes.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Spontaneous Occurrence of Heterotrophic Occurrence During Pregnancy

et al. 2023

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Heterotopic ossification (HO) typically presents in the hip, knee, and elbow joints in the setting of trauma or postsurgical intervention. Less commonly, it may occur secondary to neurologic dysfunction or underlying genetic conditions, but idiopathic HO is rare. Most cases of HO are managed nonoperatively with surgical resection remaining a controversy due to high recurrence rates. We describe a case of idiopathic HO of the shoulder that occurred in the absence of trauma, neurologic dysfunction, or underlying genetic disorder that was treated with surgical excision. Heterotopic ossification (HO) is the formation of ectopic bone within the soft tissues. 1 HO can be classified into three broad categories based on etiology: traumatic HO from fractures, dislocations, orthopaedic surgeries, and burns; neurogenic HO from spinal cord damage or head injury; and genetic HO from conditions, such as progressive fibrodysplasia ossificans or progressive osseous heteroplasia. 2 Traumatic HO comprises up to 90% of cases, most commonly a complication of arthroplasty or bone fracture, with a higher predisposition for men. 3 Although it can occur anywhere in the body, HO typically affects areas most susceptible to trauma, such as the elbow, thigh, pelvis, and shoulder. 4 When symptomatic, HO can present with pain, decreased range of motion, and in severe cases, bony ankylosis. 2 The diagnosis is made with radiographic imaging, including radiographs, CT, and MRI. Several classification systems have been used to grade the severity of HO, but the Brooker Classification System used for HO at the hip 5 and the Hastings and Graham System for HO at the elbow 6 are two of the most commonly used.A definitive diagnosis of HO can be made by histopathologic evaluation of a tissue sample. HO is often defined pathologically by the type of tissue in which it occurs, such as myositis ossificans involving skeletal muscle. The histopathologic features of the lesion typically evolve over time, with early lesions being composed of cellular fibrovascular tissue with small amounts of bone matrix. More mature lesions have prominent bone formation with a zonal architecture, a hallmark of HO. It is important to differentiate HO from a neoplastic process, such as soft-tissue sarcoma or osteosarcoma. Microscopically, in more mature lesions, trabeculae of woven bone with osteoblastic rimming accompanied by more mature lamellar bone is more

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Extensive heterotopic ossification in patient with tubercular meningitis

Cited by 5 publications

References 12 publications

Trends of main indicators of leprosy in Brazilian municipalities with high risk of leprosy transmission, 2001–2012

Trends of main indicators of leprosy in Brazilian municipalities with high risk of leprosy transmission, 2001–2012

Extensive Heterotopic Ossification of Bilateral Hip and Knee Joints in a Patient with Recurrent Traumatic Injuries

Idiopathic Spontaneous Occurrence of Heterotrophic Occurrence During Pregnancy

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