Fibrodysplasia (MYOSITIS) OSSIFICANS progressiva is rare herditary connective tissue characterized by widespread soft tissue ossification and bilateral hypoplastic hallux valgus (short big toe). Onset is typically in childhood and progressive involvement of the spine and proximal extermities leades to immobility and articular dysfunction. No effective treatment is known but it is important to avoid exacerbating factors such as biopsy, operations and intramuscular injection. We present here 16 years old man with severe restriction in pripheral and axial articular movement, bilatral hallux valgus, foci of ectopic ossification in the different site of body and conductive hearing loss in right ear.

MYOSITIS OSSIFICANS progressiva is a rare inherited disease characterized by progressive ectopic ossifications associated with thumb and big toe anomalies. Ossification usually progresses from central to the peripheral, proximal to distal, cranial to caudal, and from dorsal to ventral directions and leading to activity limitation, significant eating disability, recurrent pulmonary infection, and atelectasis. In this report, we present a 7-year-old boy with a total spine stiffness (wooden spine) seriously limited his activity of daily living.

Intra-abdominal heterotopic ossification is extremely rare with only approximately 30 cases having been reported. While most reported cases have involved the mesentery, ossification of the peritoneum is even rarer. The pathogenesis remains undetermined but is generally considered a reactive process in response to various stimuli. Histologically, it is composed of a peripheral area with bone formation and a central area of reactive hypercellular fibrous tissue. We report a rare case of intra-abdominal heterotopic ossification of the parietal peritoneum following traumatic splenic rupture.

MYOSITIS OSSIFICANS is one of elbow traumatic injury complications. In this study, a patient with MYOSITIS OSSIFICANS of elbow that has been operated and achieved good result is presented.

We describe a rare case of laryngeal fasciitis OSSIFICANS. A 58-year-old man presented with hoarseness and a nodule was found in the larynx. Excisional biopsy was performed, and follow-up laryngoscopy showed complete resolution of this reactive lesion, and normal laryngeal function. The 0.6 cm diameter nodule was well circumscribed and histologically, the lesion was composed of uniform woven bone trabeculae with rimming of osteoblasts and cellular stroma. At the periphery, uniform spindle cells actively proliferated in edematous stroma. Spindle cells were immunoreactive for vimentin andα-smooth muscle actin, suggesting myofibroblastic differentiation. Fasciitis OSSIFICANS is histologically identical to MYOSITIS OSSIFICANS, but tends to present no zonation phenomenon.Fasciitis OSSIFICANS is a rare form of heterotopic bone formation, commonly presenting with signs of local inflammation or pain. This patient’s successful outcome suggests that conservative resection may be both diagnostic and curative.

BACKGROUND AND OBJECTIVE: Fibrodysplasia OSSIFICANS progressive (FOP) or MYOSITIS OSSIFICANS progressiva is a rare hereditary connective tissue disorder. Diagnosis can be made by the typical clinical features (congenital malformations of the great toes and hallux valgus deformity) and ectopic ossification. Early diagnosis can lead to avoidance of additional harmful diagnostic and treatment procedures (such as injection and biopsy) and trauma prevention. In this report we present 2 typical cases of FOP with early and delay diagnosis. CASE: The first case was an 11 year-old girl. The first symptom was painless nodule on the skull at 2.9 years old. She had congenital malformations of the great toe and hallux valgus deformity in both feet. According to clinical findings, the diagnosis was confirmed at 3 years. She was on etidronate and she had regular follow-up every 6 months. Now, she had no any disability. The second case was a 12 year-old boy. He had had a neck mass at 18 months and he was repeatedly visited by different physicians and some unnecessary tests and procedures were done for him, but the diagnosis had a delay until 8 years old, when he referred to our pediatric rheumatology clinic. He had hallux valgus deformity and congenital malformations of the great toe in both feet. Several ectopic ossifications had occurred in abdomen wall, upper and lower limbs. Now, he walks but he cannot sit. CONCLUSION: Because tissue damage serves as a focus for ossification, early diagnosis can protect the patient from trauma and avoidance of unnecessary procedures.

Fibrodysplasia OSSIFICANS progressiva (FOP) is a rare, dominantly inherited connective tissue disorder, characterized by congenital malformations of the great toes and thumbs and progressive heterotopic ossification of soft tissues of the trunk and extremities. The ossifications typically appear within the first decade of life and result in progressive ankylosis of the joints and severe disability. So far, more than 600 cases have been reported worldwide and presently there is no effective treatment or prevention. During the early phase, particularly prior to the development of calcifications, it is often mis-diagnosed as soft tissue sarcomas or fibromatoses, which considerably delays the diagnosis, and therefore leads to unnecessary and perhaps life threatening treatments. Herein, we present a case of a 21-year-old male with FOP diagnosed late in the course of his disease.

Congenital insensitivity to pain with anhidrosis (CIPA) is the subtype four of hereditary sensory and autonomic neuropathy (HASN IV), caused by a defect in the NTRK1 gene and presenting early in life. We report a ten-year-old boy with gait problems and an inability to put weight on his feet. Four days before the visit, a trauma entered his right knee during a football match. He had swelling and erythema in his right knee and multiple scars on his torso and limbs. Magnetic resonance imaging (MRI) offered osteomyelitis and soft tissue periosteal abscess. The patient underwent an operation, and based on the pathology results, MYOSITIS OSSIFICANS (MO) was reported. Moreover, he was treated with antibiotics and supportive measures and was discharged with partial recovery. According to our knowledge, this is the first report of MO due to recurrent trauma in children with CIPA syndrome.

Background: Pediatric supracondylar humeral fractures can be associated with infectious, vascular, and neurological complications. There is debate about emergency or elective treatment methods of this fracture. The aim of this study was to evaluate the passing of time in the treatment of pediatric elbow supracondylar fractures.Methods: In this study, 60 patients underwent early surgery (before 8 hours) and 60 patients with delayed arrival underwent delayed treatment (after 8 hours). After data collection by observation and checklist they were analyzed by means of SPSS software and X2, Fisher’s exact test, t-test, and Mann-Whitney statistical test. P values of>0.05 were considered significant.Findings: There was no significant difference between the two groups regarding neurovascular injury, infection, MYOSITIS OSSIFICANS, and varus deformity. Moreover, there was no compartment syndrome in the two groups (P>0.05).Conclusion: We were unable to identify any significant differences regarding complications such as neurovascular injury, infection, MYOSITIS OSSIFICANS, and varus deformity between early and delayed treatment groups of pediatric supracondylar humeral fractures. Therefore, the choice between early or delayed operative treatment depends on the surgeon’s preference and judgment.