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Para-Articular Ossification, A Complication of Anterior Poliomyelitis.

Para-Articular Ossification, A Complication of Anterior Poliomyelitis. Para-Articular Ossification, A Complication of Anterior Poliomyelitis. A Case Report 1 Lawrence L. Larsen , M.D. 2 and Hobart H. Wright , M.D. 3 2900 W. Oklahoma Ave. Milwaukee 15, Wise. ↵ 2 Resident in Radiology, The St. Luke's Hospitals, Milwaukee, Wisc. ↵ 3 Associate Professor of Radiology, Marquette University School of Medicine, Milwaukee, Wisc. Excerpt The development of para-articular ossifications associated with anterior poliomyelitis is considered an unusual complication, although para-articular calcification and ossification are not infrequent sequelae of traumatic paraplegias or cord lesions with accompanying sensory deficits. Drehmann (1) in 1927 reported a case of para-articular calcification following acute anterior poliomyelitis in a boy two and a half years old. Three cases of myositis ossificans, all in adults, were published in 1951 by Costello and Brown (2). In 1952 Freiberg (3) reported an unusually extensive case of calcification and ossification of hips, shoulders, and metacarpophalangeal joints, and cited 2 other cases, in adults, with extensive calcifications in the hip regions. The authors recently observed an extensive ossification of the left hip in a patient in the convalescent stage of acute anterior poliomyelitis. This complication seems not to have been reported previously in the roentgen literature, except as noted by Caffey (4). B. R., a 12-year-old white girl, was admitted to South View Isolation Hospital on Sept. 10, 1955, with poliomyelitis, confirmed by laboratory findings. The immediate hospital course was one of progressive weakness of all extremities, most pronounced in the right arm and left leg. After an initial ten-day isolation period, the patient was transferred to St. Luke's Hospitals, where, in addition to the above findings, numbness of the left anterior thigh was noted. The prescribed post-polio treatments were given during the succeeding three months, but the response was not as anticipated, in that posture became progressively poorer as a result of contractures of the left hip. A careful review of the family and personal history revealed no evidence of local injury or disease of the left hip, or of previous significant illness. Preparatory to surgery for correction of contractures of the hip, roentgen studies were done on Jan. 6, 1956. These revealed an extensive para-articular ossification (Fig. 1). Laminagraphy of the involved area failed to reveal any evidence of fracture or intrinsic disease in the femur. Complete skeletal surveys showed no similar involvement elsewhere. Relevant laboratory findings were: serum total protein, 7.3 gm. per cent; serum phosphorus, 4.6 mg. per cent; serum calcium, 10.4 mg. per cent; alkaline phosphatase, 7.4 Bodansky units. Follow-up x-ray studies during the succeeding six months revealed findings consistent with bone of increasing maturity (Fig. 2). Surgical extirpation was considered advisable because of the extreme flexion contractures and fixation of the hip. Operation was performed on June 29, 1956, ten months after onset of the disease. The major muscle groups were identified and found not to be replaced by ossifying tissue. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Radiology Radiological Society of North America, Inc.

Para-Articular Ossification, A Complication of Anterior Poliomyelitis.

Radiology , Volume 69 (1): 103 – Jul 1, 1957

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Publisher
Radiological Society of North America, Inc.
Copyright
Copyright © 1957 by Radiological Society of North America
ISSN
1527-1315
eISSN
0033-8419
DOI
10.1148/69.1.103
pmid
13453722
Publisher site
See Article on Publisher Site

Abstract

Para-Articular Ossification, A Complication of Anterior Poliomyelitis. A Case Report 1 Lawrence L. Larsen , M.D. 2 and Hobart H. Wright , M.D. 3 2900 W. Oklahoma Ave. Milwaukee 15, Wise. ↵ 2 Resident in Radiology, The St. Luke's Hospitals, Milwaukee, Wisc. ↵ 3 Associate Professor of Radiology, Marquette University School of Medicine, Milwaukee, Wisc. Excerpt The development of para-articular ossifications associated with anterior poliomyelitis is considered an unusual complication, although para-articular calcification and ossification are not infrequent sequelae of traumatic paraplegias or cord lesions with accompanying sensory deficits. Drehmann (1) in 1927 reported a case of para-articular calcification following acute anterior poliomyelitis in a boy two and a half years old. Three cases of myositis ossificans, all in adults, were published in 1951 by Costello and Brown (2). In 1952 Freiberg (3) reported an unusually extensive case of calcification and ossification of hips, shoulders, and metacarpophalangeal joints, and cited 2 other cases, in adults, with extensive calcifications in the hip regions. The authors recently observed an extensive ossification of the left hip in a patient in the convalescent stage of acute anterior poliomyelitis. This complication seems not to have been reported previously in the roentgen literature, except as noted by Caffey (4). B. R., a 12-year-old white girl, was admitted to South View Isolation Hospital on Sept. 10, 1955, with poliomyelitis, confirmed by laboratory findings. The immediate hospital course was one of progressive weakness of all extremities, most pronounced in the right arm and left leg. After an initial ten-day isolation period, the patient was transferred to St. Luke's Hospitals, where, in addition to the above findings, numbness of the left anterior thigh was noted. The prescribed post-polio treatments were given during the succeeding three months, but the response was not as anticipated, in that posture became progressively poorer as a result of contractures of the left hip. A careful review of the family and personal history revealed no evidence of local injury or disease of the left hip, or of previous significant illness. Preparatory to surgery for correction of contractures of the hip, roentgen studies were done on Jan. 6, 1956. These revealed an extensive para-articular ossification (Fig. 1). Laminagraphy of the involved area failed to reveal any evidence of fracture or intrinsic disease in the femur. Complete skeletal surveys showed no similar involvement elsewhere. Relevant laboratory findings were: serum total protein, 7.3 gm. per cent; serum phosphorus, 4.6 mg. per cent; serum calcium, 10.4 mg. per cent; alkaline phosphatase, 7.4 Bodansky units. Follow-up x-ray studies during the succeeding six months revealed findings consistent with bone of increasing maturity (Fig. 2). Surgical extirpation was considered advisable because of the extreme flexion contractures and fixation of the hip. Operation was performed on June 29, 1956, ten months after onset of the disease. The major muscle groups were identified and found not to be replaced by ossifying tissue.

Journal

RadiologyRadiological Society of North America, Inc.

Published: Jul 1, 1957

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