Presentation
History and Physical Examination
After arthroplasty, heterotopic ossification (HO) can be noted in either of the following two ways:
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The condition can be a cause of physical symptoms, notably pain and stiffness
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The condition may be entirely asymptomatic and may be detected radiologically on follow-up films
A person who has symptomatic HO may present with a loss of range of movement in the affected joint. This may coexist with pain and soft-tissue swelling. Differential diagnoses of this clinical picture would include the following:
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Trauma to the soft tissue or fracture
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Infective or inflammatory processes, such as cellulitis, erysipelas, thrombophlebitis, septic arthritis, and osteomyelitis
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Neoplasia of local soft tissue or bone
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Vascular or blood-related conditions such as wound hematoma or deep vein thrombosis
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Complications
HO may cause pain and stiffness. In turn, joint stiffness may cause further contractures. In severe cases, joint ankylosis may result. Nerve entrapment across joints also may be a complication of HO. Rare cases of HO undergoing malignant sarcomatous change have been reported.
Previous
Media Gallery
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Brooker I heterotopic ossification associated with an uncemented total hip arthroplasty.
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Brooker I heterotopic ossification associated with a cemented total hip replacement that has undergone acetabular component augmentation and fixation of the greater trochanter.
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Brooker II heterotopic ossification associated with a right cemented total hip replacement. On the left side, an uncemented total hip arthroplasty is present with no heterotopic ossification.
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Brooker III heterotopic ossification associated with a left uncemented total hip arthroplasty.
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Brooker I heterotopic ossification associated with a revision hip arthroplasty.
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Brooker II heterotopic ossification associated with a right revision hip arthroplasty.
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Brooker I heterotopic ossification associated with bilateral revision hip arthroplasties.
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