Heterotopic Ossification of the Hindfoot A Case Report
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Abstract
We present a case of heterotopic ossification that spontaneously developed on the plantar surface of the left heel of a 38-year-old Filipino man. The diagnosis was made using plain radiography and a CT scan. Grossly, the mass resected was composed of discrete, mature bone tissue surrounded by extra-skeletal soft tissue, typical of heterotopic ossification. Histopathologic examination revealed a benign appearing bony tissue admixed with cartilaginous, fibromuscular, fibrocollagenous, and adipose tissues, further confirming the diagnosis.
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References
1. Meyers C, Lisiecki J, Miller S, et al. Heterotopic ossification: a comprehensive review. JBMR Plus. 2019;3(4):e10172. https://pubmed.ncbi.nlm.nih.gov/31044187 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6478587 https://doi.org/10.1002/jbm4.10172
2. Mavrogenis AF, Soucacos PN, Papagelopoulos PJ. Heterotopic ossification revisited. Orthopedics. 2011;34(3):177. https://pubmed.ncbi.nlm.nih.gov/21410128 https://doi.org/10.3928/01477447-20110124-08
3. Edwards DS, Clasper JC. Heterotopic ossification: a systematic review. J R Army Med Corps. 2015;161(4):315-21. https://pubmed.ncbi.nlm.nih.gov/25015927 https://doi.org/10.1136/jramc-2014-000277
4. Danya F, Marco B, Valentino C, Mario M, Antonio Pompilio G. Case report: unusual heterotopic ossification of the hindfoot. Front Surg. 2022;9:917560. https://pubmed.ncbi.nlm.nih.gov/35747430 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9209653 https://doi.org/10.3389/fsurg.2022.917560
5. Page TS, Hyer CF. Massive intracapsular heterotopic ossification of the anterior ankle joint after talar neck fracture: an unusual case study. Foot Ankle Surg. 2021;1(2):100026. https://doi.org/10.1016/j.fastrc.2021.100026
6. Cao G, Zhang S, Wang Y, et al. Pathogenesis of acquired heterotopic ossification: Risk factors, cellular mechanisms, and therapeutic implications. Bone. 2023;168:116655. https://pubmed.ncbi.nlm.nih.gov/36581258 https://doi.org/10.1016/j.bone.2022.116655
7. Hong CC, Nashi N, Hey HW, Chee YH, Murphy D. Clinically relevant heterotopic ossification after elbow fracture surgery: a risk factors study. Orthop Traumatol Surg Res. 2015;101(2):209-13. https://pubmed.ncbi.nlm.nih.gov/25701160 https://doi.org/10.1016/j.otsr.2014.10.021
8. Licini C, Farinelli L, Cerqueni G, et al. Heterotopic ossification in a patient with diffuse idiopathic skeletal hyperostosis: Input from histological findings. Eur J Histochem. 2020;64(4):3176. https://pubmed.ncbi.nlm.nih.gov/33272008 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731577 https://doi.org/10.4081/ejh.2020.3176
9. Kaushal J, Rakesh A, Kaushal A, Vermani S, Kaushal L. Heterotopic ossification at an unusual site: a case report. Int J Sci Stud 2020;8(4):5-8.
10. Xu Z, Rao ZZ, Tang ZW, et al. Post-traumatic heterotopic ossification in front of the ankle joint for 23 years: A case report and review of literature. World J Clin Cases. 2023;11(1):193-200. https://pubmed.ncbi.nlm.nih.gov/36687178 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9846978 https://doi.org/10.12998/wjcc.v11.i1.193
11. Barlaan PI, Ip WY. Heterotopic ossification in the middle finger: a case report. Case Rep Orthop. 2011;2011:323795. https://pubmed.ncbi.nlm.nih.gov/23198207 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3504241 https://doi.org/10.1155/2011/323795
12. Kanani J, Sheikh MI. A puzzling case: a unique presentation of massive heterotopic ossification on the spleen’s outer surface. J Med Surg Public Health. 2024;2(1):100080. https://doi.org/10.1016/j.glmedi.2024.100080
13. Somani V, Shaikh A, Desai MM, Gupta R. A rare case of extensive neurogenic heterotopic ossification: a case report. BMC Musculoskelet Disord. 2024;25(1):313. https://pubmed.ncbi.nlm.nih.gov/38654259 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11036736 https://doi.org/10.1186/s12891-024-07369-2
14. Oliveira A, Rosenberg AE. Myositis ossificans and fibroosseous pseudotumor of the digits. In: WHO Classification of Tumours Editorial Board. Soft tissue and bone tumours, 5th ed. Lyon, France: International Agency for Research on Cancer; 2020. WHO classification of tumours series, vol. 3). https://tumourclassification.iarc.who.int/chaptercontent/33/19
15. Kirkpatrick J, Yassaie O, Mirjalili SA. The plantar calcaneal spur: a review of anatomy, histology, etiology and key associations. J Anat. 2017;230(6):743-51. https://pubmed.ncbi.nlm.nih.gov/28369929 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5442149 https://doi.org/10.1111/joa.12607
16. Menz HB, Thomas MJ, Marshall M, et al. Coexistence of plantar calcaneal spurs and plantar fascial thickening in individuals with plantar heel pain. Rheumatology (Oxford). 2019;58(2):237-45. https://pubmed.ncbi.nlm.nih.gov/30204912 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519610 https://doi.org/10.1093/rheumatology/key266
17. Johal KS, Milner SA. Plantar fasciitis and the calcaneal spur: fact or fiction? Foot Ankle Surg. 2012;18(1):39-41. https://pubmed.ncbi.nlm.nih.gov/22326003 https://doi.org/10.1016/j.fas.2011.03.003
18. Drake C, Whittaker GA, Kaminski MR, et al. Medical imaging for plantar heel pain: a systematic review and meta-analysis. J Foot Ankle Res. 2022;15(1):4. https://pubmed.ncbi.nlm.nih.gov/35065676 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8783477 https://doi.org/10.1186/s13047-021-00507-2