A Case of Calcific Myonecrosis: A Rare Clinical Presentation

Calcific myonecrosis, a complication of late compartment syndrome, is a rare disorder characterized by peripheral calcification and central liquefaction of the entire muscle mass. We present a case of myositis ossificans impersonation that was not only unusual but also posed difficulty in diagnosis...

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Main Authors: Dhanasegaran Arunachalam, Balasubramaniam Ramasamy, Lalithambigai Chellamuthu
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2023-07-01
Series:Journal of Orthopedics and Joint Surgery
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Online Access:https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1113
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author Dhanasegaran Arunachalam
Balasubramaniam Ramasamy
Lalithambigai Chellamuthu
author_facet Dhanasegaran Arunachalam
Balasubramaniam Ramasamy
Lalithambigai Chellamuthu
author_sort Dhanasegaran Arunachalam
collection DOAJ
description Calcific myonecrosis, a complication of late compartment syndrome, is a rare disorder characterized by peripheral calcification and central liquefaction of the entire muscle mass. We present a case of myositis ossificans impersonation that was not only unusual but also posed difficulty in diagnosis and therapeutic management. The patient was a 45-year-old man presented with right leg pain and swelling for 6 months with no constitutional symptoms. He also had a history of trauma 1 year ago. Clinically, the swelling was multilobulated, fluctuant, and tender over the mid-anterolateral aspect of right leg. Neurological examination revealed right ankle dorsiflexion and eversion of right foot. X-ray of right leg full length revealed a homogeneous radiopaque lesion over the anterior and lateral aspect. Magnetic resonance imaging (MRI) suggested a myositis ossificans lesion limited to the right leg's lateral and anterior compartments, with no hypervascularity. Routine blood tests, including liver function test, serum calcium, phosphorus, and alkaline phosphatase levels, were all normal. A nerve conduction study revealed that the right superficial and deep peroneal nerves had a lower conduction velocity. The tru-cut biopsy revealed myositis ossificans. Pus from the excision biopsy was sent for histopathological analysis, and the results revealed calcific myonecrosis. Following excision, along with physiotherapy and a course of indomethacin, patient got relieved off his symptoms and on follow-up had no signs of recurrence.
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spelling doaj-art-a495605f9d3f47a4835e320c6ba7e4b22025-08-20T03:44:32ZengJaypee Brothers Medical PublisherJournal of Orthopedics and Joint Surgery2582-78632023-07-015210110410.5005/jojs-10079-111312A Case of Calcific Myonecrosis: A Rare Clinical PresentationDhanasegaran Arunachalam0Balasubramaniam Ramasamy1Lalithambigai Chellamuthu2Department of Orthopaedics, Sri Venkateshwaraa Medical College Hospital & Research Centre, Puducherry, India, Phone: +91 9789349881Department of Orthopaedics, Sri Venkateshwaraa Medical College Hospital & Research Centre, Puducherry, IndiaDepartment of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Puducherry, IndiaCalcific myonecrosis, a complication of late compartment syndrome, is a rare disorder characterized by peripheral calcification and central liquefaction of the entire muscle mass. We present a case of myositis ossificans impersonation that was not only unusual but also posed difficulty in diagnosis and therapeutic management. The patient was a 45-year-old man presented with right leg pain and swelling for 6 months with no constitutional symptoms. He also had a history of trauma 1 year ago. Clinically, the swelling was multilobulated, fluctuant, and tender over the mid-anterolateral aspect of right leg. Neurological examination revealed right ankle dorsiflexion and eversion of right foot. X-ray of right leg full length revealed a homogeneous radiopaque lesion over the anterior and lateral aspect. Magnetic resonance imaging (MRI) suggested a myositis ossificans lesion limited to the right leg's lateral and anterior compartments, with no hypervascularity. Routine blood tests, including liver function test, serum calcium, phosphorus, and alkaline phosphatase levels, were all normal. A nerve conduction study revealed that the right superficial and deep peroneal nerves had a lower conduction velocity. The tru-cut biopsy revealed myositis ossificans. Pus from the excision biopsy was sent for histopathological analysis, and the results revealed calcific myonecrosis. Following excision, along with physiotherapy and a course of indomethacin, patient got relieved off his symptoms and on follow-up had no signs of recurrence.https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1113calcific myonecrosiscompartment syndromemyositis ossificansneurological weaknesssofttissue calcified mass
spellingShingle Dhanasegaran Arunachalam
Balasubramaniam Ramasamy
Lalithambigai Chellamuthu
A Case of Calcific Myonecrosis: A Rare Clinical Presentation
Journal of Orthopedics and Joint Surgery
calcific myonecrosis
compartment syndrome
myositis ossificans
neurological weakness
softtissue calcified mass
title A Case of Calcific Myonecrosis: A Rare Clinical Presentation
title_full A Case of Calcific Myonecrosis: A Rare Clinical Presentation
title_fullStr A Case of Calcific Myonecrosis: A Rare Clinical Presentation
title_full_unstemmed A Case of Calcific Myonecrosis: A Rare Clinical Presentation
title_short A Case of Calcific Myonecrosis: A Rare Clinical Presentation
title_sort case of calcific myonecrosis a rare clinical presentation
topic calcific myonecrosis
compartment syndrome
myositis ossificans
neurological weakness
softtissue calcified mass
url https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1113
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