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November 29, 2016 00:12

Myositis ossificans |Symptoms and treatment of myositis ossificans

myositis ossificans - a pathological illness affecting muscle tissue.Consider the causes of the disease, symptoms, diagnosis and treatment.

Myositis is a group of inflammatory conditions affecting skeletal muscle.The main symptom of disease - it is localized pain in the muscle, which is reinforced with movement and palpation.Myositis ossificans is a partial ossification of muscles.The disease is a rare form of polymyositis that develops after trauma, sprains and torn ligaments, fractures and dislocations.Myositis may develop on the background of fibromiozita, ie the substitution of damaged muscle connective tissue fibers.

main forms of myositis:

  • ossificans - occurs after a trauma, but may be congenital, characterized by the deposition of calcifications in the muscles.
  • Polymyositis - an inflammatory disease of the muscles caused by cytomegalovirus and coxsackie virus.
  • infectious (purulent) - occurs when bacterial and viral infection, sexually transmitted diseases.
  • Festering - may be the result o
    f chronic osteomyelitis or septicopyemia.
  • Dermatomyositis - defeat exposed not only muscle tissue, but also the skin.
  • parasitogenic - occurs when toxic-allergic reactions to parasitic infection.

myositis ossificans causes deformation of the extremities, and the appearance of severe pain, resulting in decreased mobility.In addition there is a seal muscle sites.In the initial stages of pathology provokes inflammation of the muscle, which is why there is swelling, redness and pain.Over time the scar ossified and leads to compaction.When attempting a palpation can be detected quite solid portions that do not differ from the bone.These fate deformed limbs due to accretion of bones.

Typically, ossification occurs in the muscles of the thigh and shoulder muscles.In the pathology of shoulder muscle movements in the elbow joint are limited to complete immobilization.With the defeat of the average head quadriceps strain undergoes knee.

myositis ossificans has several forms, look at each of them:

  • Traumatic - this form is characterized by rapid progression and form a solid component within the muscle, which when taken for biopsy sarcoma.It is because of errors in the process of diagnosis and treatment of disease causes a number of serious complications.
  • Trofonevrotichesky - develops because of traumatism of major nerve trunks.As a rule, it affects knee and hip joints.
  • Progressive myositis - can begin to develop in utero formation of the fruit, but it manifests itself in the first year of life.Most often it occurs in boys.Causes muscle stiffness, limitation of movement and change in posture.

reasons ossificans myositis ossificans

myositis reasons lie in pathological physiological processes denervirovaniya muscle fibers.The disease may develop due to exposure to various types of toxic substances.Toxic myositis occurs in alcoholism and drug addiction.Acceptance of certain medications also can cause unstable muscle damage.But the exact pathogenesis of the disease is not known.Ossification may be formed in a few weeks, or even years.

Very often the disease occurs on the background of osteomyelitis, erysipelas skin inflammation, cystitis with stones in the bladder.Various viral diseases, bacterial and fungal infections, also provoked myositis.Myositis medium and low severity occur after various injuries, hypothermia, muscle cramps, intense exercise.The risk of developing myositis occurs in people of certain professions - musicians, drivers, computer operators.Long-term stress on certain muscle groups and provoke an uncomfortable posture pathology.

Symptoms ossificans myositis ossificans

symptoms of myositis are growing character.Often, the disease occurs in young men and 50% of cases due to injury and mechanical damage.localized foci of inflammation in skeletal muscle, the advantage of its deep divisions.Less inflammation begins near the periosteum.Generally, myositis ossificans affects the thighs, buttocks, upper and lower limbs, shoulder area.

Consider the basic symptoms that occur as the disease progresses:

  • arises mild swelling that resembles dough consistency on palpation on the affected surface.
  • Through time the affected tissue begin to thicken due to ossification.Typically, during this period, and beginning to identify disease treatment.
  • Node ossification surrounded by muscle mass, which, due to degenerative processes became like jelly.Perhaps the proliferation of fibrous tissue and the replacement unit formed bone penetrated by fibrous tissue and cysts.

clinical picture of the disease depends entirely on the nature of the damage caused by myositis.If the damaged blood vessels, and the injury is serious, the symptoms are progressive.Within a month on the affected limb pain and swelling occurs, at which point the inflammatory process.In this case, the patient waiting for surgery in the first months after the detection of pathology.If myositis ossificans appears on the background of secondary micro traumas, the disease is asymptomatic, only the patient's complaint - a slight swelling in the lesion.

myositis ossificans traumatic

myositis ossificans is a traumatic extraskeletal ossification of muscle tissue after injuries.Illness arises from the acute and chronic damage that is a result of sprains, bruises, sprains, fractures, often repetitive minor trauma (the athletes and people of certain professions).

ossification exposed shoulder muscles (due to posterior dislocation of the forearm), as well as leading and quadriceps, gluteus medius muscle.This pathology is often seen at football players on the outside of the thigh due to injuries.Less traumatic myositis ossificans is formed in the shoulder girdle, muscles of the lower leg and forearm.Regular reduction of dislocation, traumatic surgery and a number of other factors contribute to the development of myositis ossificans.

  • first symptoms appear 2-3 weeks after injury.In the area of ​​the damaged muscles growing pain, swelling and markedly growing seal.After 1-2 months the seal becomes the bone and pain subside.Since the new formed bone is close to the joint, it is limited in its movement.In some cases, muscle ossification ossification occurs simultaneously with other tissues, which can cause ankylosis.
  • Identify traumatic form of the disease is a differential diagnosis.Pathology of muscle tissue should be separated from possible ossification joint capsule and ligaments, bruises, pathologies of nontraumatic origin, fibroids, synovitis and other diseases.
  • treatment of any injuries begins with immobilization of the affected limb and casting of the 10 days.This is necessary in order to prevent the development of myositis ossificans.If this is not done, then begin ossification and conservative treatment does not work in 1-3 months after the injury.In this case the patient awaits surgery, and complete removal of bone formed together with the capsule.Forecast traumatic forms of myositis favorable, since the illness does not cause irreversible disorders of the joints movement.

Progressive myositis ossificans

Progressive myositis ossificans - this disease is a hereditary character, that is innate.The illness is characterized by a long progressive course, which entails a violation of the musculoskeletal system and can lead to disability in patients even childhood.

Myunhmeyera syndrome or progressive myositis ossificans is most often diagnosed in male patients.Symptoms can appear immediately after birth or at a young age, causing a gradual ossification of muscle tissue.On palpation of damaged areas of tissue density felt, but pain does not occur.Myositis leads to an unnatural body position, limits movement of the joints or completely immobilizes them.

  • treatment does not bring proper efficiency.But there are a number of recommendations, which do not allow the disease to progress.Patients should be special diet with minimal calcium in food.As for surgery, many doctors believe it is pointless, and in some cases dangerous, because the operation can cause ossification growth.
  • If the disease is uncomplicated, for the treatment of used anti-inflammatory and desensitizing agents, biostimulants and various vitamins.In complicated form of myositis therapy is hormonal drugs and steroids.Many important rule of treatment - a waiver of any intramuscular injection, as they can become new centers of ossification.

myositis ossificans hip

hip myositis ossificans is a pathological process that causes muscle tissue lose elasticity.The disease has a long progressive course, ie ossification formed within a few months and can not be felt.Various injuries, dislocations and sprains cause damage to the muscle fibers and myositis.To date, there are three forms of myositis ossificans thigh:

  • ossification is connected to the hip bone presenting with a jumper.
  • periosteal form - ossification in contact with the femur.
  • ossification has a wide base and a part of ectopic bone acts as the thickness of the quadriceps.

The most common lesion volume is limited to the middle third of the thigh, but can extend up to the proximal third.They diagnose the disease in a few weeks or even a month after the trauma.The patient complains of swelling, which becomes painful, and the skin over it hot to the touch.For diagnosis using X-ray, which shows the degree of deformation of the muscle and bone of the thigh.

If the disease is detected at an early stage, treatment is a joint immobilization and conservative therapy.But even with complex forms of myositis ossificans hip surgery is not carried out.All therapy reduces to receive medicines and physiotherapy.

Diagnostics ossificans myositis ossificans

myositis diagnosis is based on typical clinical picture of the disease.The patient complains of a dull aching pain, muscle weakness and discomfort when trying to palpation of the affected area.Very often when probing possible to determine the presence of nodules and cords in the muscles.In addition, the presence of myositis show characteristic changes in the general analysis of blood.

survey process begins with consultation and examination, the results of which the doctor prescribes further laboratory and instrumental examinations.Consider the basic steps of the diagnosis of myositis ossificans:

  1. History taking and examination

The doctor asks the patient about the beginning of the disease, trauma and other pathologies of the organism.After that, the patient is waiting for inspection.The doctor visualizes potential site failure, examine the skin.If myositis progresses for a long time, it causes muscle atrophy, and the skin over this area is sparse mesh of blood vessels, that is pale.The affected muscle tone overtures to assess and identify the tender points.Myositis ossificans is characterized by progressive muscle weakness, so moderate pain on palpation, but the muscles tight.

Roentgen X-ray picture of myositis ossificans has a certain appearance.For example, in damaged muscle tissue visible shadows of irregular shape, which are on increase in muscle fibers can fuse with bone or go isolated from them.It is this sign indicates the presence of myositis and ossification.

  1. Revmoproby

Revmoproby are tests that are required for the differentiation of local and systemic rheumatic diseases.Revmoproby needed to determine the etiology of the disease, and autoimmune diseases exceptions.In addition, this study allows you to set the intensity of the inflammatory process.Revmoproby consist of indicators such as: •

C-reactive protein - an increased concentration of the substance indicates inflammation in the body.This is sort of a marker of acute inflammation phase, it is diagnosed at an exacerbation of chronic myositis and infectious forms of the disease.This figure is not only used for differential diagnosis, but evaluates the effectiveness of the treatment.

  • antistreptolisin-O - is an antibody that is produced in the presence of the body of streptococcal infection.It allows you to identify rheumatism and rheumatoid arthritis.
  • Revmofaktor - higher values ​​of antibodies indicate an autoimmune disease, rheumatoid seropositive artit or dermatomyositis.The analysis is performed prior to treatment and after primary therapy.
  • Myositis-specific autoantibodies - a marker for the detection of dermatomyositis, polymyositis and myositis with inclusions.The most common antibodies are: anti Jo-1 - 90% of patients with myositis, anti-Mi-2 - 95% of patients with dermatomyositis and anti-SRP - 4% of patients with myositis.
  1. Morphological examination

This type of diagnosis is a biopsy.That is taking a biopsy for a thorough examination.The main purpose of the study - is to identify structural degenerative changes in the muscles and connective tissue surrounding the blood vessels.The main indications for biopsy: infectious myositis, polymyositis and polifibromiozity.

But as a rule, all of the above diagnostic methods for the detection of myositis ossificans used X-rays, CT scans and radioisotope research diseased muscle tissue.

myositis ossificans treatment

Treatment of myositis ossificans is the responsibility of doctors, as a therapist, rheumatologist and neurologist.Initial examination of the therapist holds, and then, depending on the etiology of the disease provides referral to other professionals.If ossification were identified at an early stage, it is used for the treatment of physiotherapy (electrophoresis, ultrasound, etc.) for sucking ossification and analgesia.

treatment fails in a hospital, but the patient must go to a regular inspection and procedures prescribed by a doctor.The mainstay of treatment - is compliance with bed rest, that is necessary to ensure complete rest of the affected area of ​​the body.The patient is prescribed a special diet that consists of fruits, cereals and vitamins E and C. This is strictly prohibited sharp, salty, fried and fatty foods, and alcohol.

  • If myositis is caused by parasites that prescribed anthelmintic drugs for bacterial lesions - antibiotics and serum.
  • purulent form of the disease requires surgical treatment - autopsy ulcer, installation of drainage and washing the wound with antiseptic.
  • autoimmune disease because the patient is prescribed Immunosuppressive and glucocorticosteroids.In severe cases, a cytapheresis and plasmapheresis, ie methods

extracorporeal detoxification myositis ossificans amenable to conservative treatment only in the early stages, surgery is performed in all other cases.This is due to the fact that initially dissolve disease calcification by the action of various drugs.