The use of spect/ct in the evaluation of heterotopic ossification in para/tetraplegics

Heterotopic ossification (HO) is a common occurrence after multiple forms of extensive trauma. These include arthroplasties, traumatic brain and spinal cord injuries, extensive burns in the civilian setting, and combat-related extremity injuries in the battlefield. Irrespective of the form of trauma, heterotopic bone is typically endochondral in structure and is laid down via a cartilaginous matrix. Once formed, the heterotopic bone typically needs to be excised surgically, which may result in wound healing complications, in addition to a risk of recurrence. Refinements of existing diagnostic modalities, like micro- and nano-CT are being adapted toward early intervention. Trauma-induced HO is a consequence of aberrant wound healing, systemic and local immune system activation, infections, extensive vascularization, and innervation. This intricate molecular crosstalk culminates in activation of stem cells that initiate heterotopic endochondral ossification. Development of animal models recapitulating the unique traumatic injuries has greatly facilitated the mechanistic understanding of trauma-induced HO. These same models also serve as powerful tools to test the efficacy of small molecules which specifically target the molecular pathways underlying ectopic ossification. This review summarizes the recent advances in the molecular understanding, diagnostic and treatment modalities in the field of trauma-induced HO.

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“…35,41 In addition, SPECT imaging modalities can be added to CT imaging to improve the assessment of sites of inflammation. 42…”

Section: Diagnostics: Ct Raman Nir Ultrasoundmentioning

confidence: 99%

The traumatic bone: trauma-induced heterotopic ossification

Dey

Wheatley

Cholok

et al. 2017

Translational Research

112

108

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“…Nuclear medicine modalities can also be useful and provide metabolic and functional information on developing HO. The scintigraphy, including planar bone scan and single-photon emission computed tomography (SPECT), is proven to be a highly sensitive method in HO detection [ 53 , 54 ]. Similarly, the positron emission tomography (PET) can be useful in the HO diagnosis and successfully identify early HO and chronic lesions [ 55 ].…”

Section: Heterotopic Ossification As a Clinical Issuementioning

confidence: 99%

The Survey of Cells Responsible for Heterotopic Ossification Development in Skeletal Muscles—Human and Mouse Models

Pulik

Mierzejewski

Ciemerych

et al. 2020

Cells

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Heterotopic ossification (HO) manifests as bone development in the skeletal muscles and surrounding soft tissues. It can be caused by injury, surgery, or may have a genetic background. In each case, its development might differ, and depending on the age, sex, and patient’s conditions, it could lead to a more or a less severe outcome. In the case of the injury or surgery provoked ossification development, it could be, to some extent, prevented by treatments. As far as genetic disorders are concerned, such prevention approaches are highly limited. Many lines of evidence point to the inflammatory process and abnormalities in the bone morphogenetic factor signaling pathway as the molecular and cellular backgrounds for HO development. However, the clear targets allowing the design of treatments preventing or lowering HO have not been identified yet. In this review, we summarize current knowledge on HO types, its symptoms, and possible ways of prevention and treatment. We also describe the molecules and cells in which abnormal function could lead to HO development. We emphasize the studies involving animal models of HO as being of great importance for understanding and future designing of the tools to counteract this pathology.

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“…One of these modalities is single-photon emission computed tomography (SPECT), which is able to correlate metabolic activity using radioisotope uptake with the presence of osseous lesions (Fig 2). Areas of early HO may be non-ossified but have high metabolic activity, indicated by increased up take of the radioisotope (35, 36). Studies are now underway to determine whether SPECT can guide extent of surgical excision, or whether evidence of metabolic activity can guide therapeutic intervention.…”

Section: Diagnosismentioning

confidence: 99%

Heterotopic Ossification Following Upper Extremity Injury

2017

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Synopsis Heterotopic ossification (HO) presents a substantial barrier to rehabilitation for patients with severe burns or trauma. Although surgical excision is a mainstay of management for this condition, this is unable to address the chronic sequelae of HO including chronic pain, joint contractures, nerve dysfunction, and open wounds. Current therapeutic modalities are aimed towards excision and the prevention of recurrence using NSAIDs or radiation therapy. Research is now focused on identifying alternative strategies to prevent the initial occurrence of HO through NSAIDs and novel inhibitors of the bone morphogenetic protein (BMP) signaling pathway.

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The use of spect/ct in the evaluation of heterotopic ossification in para/tetraplegics

Cited by 12 publications

References 17 publications

The traumatic bone: trauma-induced heterotopic ossification

The traumatic bone: trauma-induced heterotopic ossification

The Survey of Cells Responsible for Heterotopic Ossification Development in Skeletal Muscles—Human and Mouse Models

Heterotopic Ossification Following Upper Extremity Injury

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