Why does myositis ossificans occur

We know you want what's best for your child. We're ready to assist you with your questions. Sports Medicine What is Myositis Ossificans? Lower Extremity Fractures. What is Myositis Ossificans? Osteochondritis Dissecans. Stress Fracture. When a muscle is injured or bruised, bony tissue can be deposited into the bruise during the healing process. While the exact cause of this reaction is unknown, athletes who subject the area to repetitive trauma before it is able to fully heal are more likely to have calcification and bony formation in the injured muscle.

Additionally, not taking measures to reduce inflammation in the muscle after the initial injury also leads to in an increased risk of developing myositis ossificans. Calcification typically occurs weeks after the initial muscle injury and the bone fully matures by months.

Persistent pain in previously injured muscle. While muscles can take months to get back to full strength following a strain or a bruise, typically, after weeks there should be continued improvement in pain and performance. If pain, range of motion, and strength have not begun to improve or get worse at a month after the injury, the cause could be myositis ossificans. In addition to pain, swelling or a hard bump are signs of myositis ossificans.

A sports medicine physician will ask the athlete questions about the initial injury as well as their progression, including improvement or worsening of symptoms. The physician will examine the affected area to determine the location of the pain and assess strength or flexibility. They may watch the athlete walk, run, jump, or balance. If there is suspicion of myositis ossificans, either an ultrasound or x-ray will be performed to assess for calcifications within the muscle.

Sometimes, radiographs initially will be negative and, at a later date, show bone tissue. Serial imaging to follow the progression of the bone formation may be obtained at subsequent appointments. MRIs are not typically ordered unless there are questions regarding the diagnosis, or there are concerns for complications. Treatment is initially conservative, as calcifications can be reabsorbed by the body, and some patients can fully recover despite calcifications, if treated properly.

Conservative treatment includes rest from activities that strain the muscles, or less commonly, immobilization of the affected muscle. These measures that limit further repetitive trauma can promote spontaneous resorption of the calcification, and thus, healing.

Anti-inflammatory medications such as naproxen or ibuprofen may help but using these is controversial; these medications may also increase the risk of bleeding into the muscle early in the course of the injury. Physical therapy is commonly prescribed. Initially, after a muscle injury, aggressive stretching should be avoided, as this can increase bleeding or inflammation.

Eventually, this can cause a hard lump or bump to develop within the muscle. This is a gradual process and begins within a few weeks after the initial injury. It can be hard to predict who will get myositis ossificans, but the condition is more prevalent in active young adults and athletes.

Myositis ossificans occurs in people who participate in sport at all levels, from those who are playing just for fun through to highly competitive or professional athletes. Also, people who are paralyzed from the waist down are more likely to develop myositis ossificans, even if they do not have a specific injury.

Unlike other typical muscle strains or injuries, people with myositis ossificans may notice that their pain worsens with time instead of getting better.

Before diagnosing myositis ossificans, a doctor will ask about what happened, how long ago it happened, the symptoms, and what steps a person has taken to manage the pain or injury. If it has been at least 2—3 weeks since the pain or other symptoms started, the doctor may order some imaging tests to look for evidence of bone growth in the soft tissue. Sometimes, early diagnostic testing can confuse myositis ossificans with certain types of soft tissue cancers. As a result, the doctor may order additional testing to confirm the diagnosis.

Myositis ossificans usually resolves on its own. Taking pain relievers, such as naproxen or ibuprofen, can help relieve discomfort. After the first 48 to 72 hours, a person can start physical therapy to build up strength in the muscle. Therapy should start with an assisted range of motion exercises — this involves moving the joints slowly and gently in all directions to see how far they will go — and gradually progressing into full dynamic exercise as the muscle regains strength. If pain relievers, physical therapy, and other home care measures are not effective in treating myositis ossificans, surgical removal of the growth may be needed.

The doctor or surgeon may recommend delaying surgery for a period to reduce the risk that myositis ossificans will reoccur. While it can be difficult to predict who will get myositis ossificans, it is important to treat every injury promptly using the R. This is:. An athlete who sustains an injury may need to leave the game or event, especially if there is significant swelling or bruising.