1 / 13

MSK Case Presentation

<?xml version="1.0"?><AllQuestions />. <?xml version="1.0"?><AllResponses />.

idona-armstrong
Télécharger la présentation

MSK Case Presentation

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. <?xml version="1.0"?><AllQuestions /> <?xml version="1.0"?><AllResponses /> <?xml version="1.0"?><Settings><answerBulletFormat>Numeric</answerBulletFormat><answerNowAutoInsert>No</answerNowAutoInsert><answerNowStyle>Explosion</answerNowStyle><answerNowText>Answer Now</answerNowText><chartColors>Use PowerPoint Color Scheme</chartColors><chartType>Horizontal</chartType><correctAnswerIndicator>Checkmark</correctAnswerIndicator><countdownAutoInsert>No</countdownAutoInsert><countdownSeconds>10</countdownSeconds><countdownSound>TicToc.wav</countdownSound><countdownStyle>Box</countdownStyle><gridAutoInsert>No</gridAutoInsert><gridFillStyle>Answered</gridFillStyle><gridFillColor>255,255,0</gridFillColor><gridOpacity>50%</gridOpacity><gridTextStyle>Keypad #</gridTextStyle><inputSource>Response Devices</inputSource><multipleResponseDivisor># of Responses</multipleResponseDivisor><participantsLeaderBoard>5</participantsLeaderBoard><percentageDecimalPlaces>0</percentageDecimalPlaces><responseCounterAutoInsert>No</responseCounterAutoInsert><responseCounterStyle>Oval</responseCounterStyle><responseCounterDisplayValue># of Votes Received</responseCounterDisplayValue><insertObjectUsingColor>Red</insertObjectUsingColor><showResults>Yes</showResults><teamColors>Use PowerPoint Color Scheme</teamColors><teamIdentificationType>None</teamIdentificationType><teamScoringType>Voting pads only</teamScoringType><teamScoringDecimalPlaces>1</teamScoringDecimalPlaces><teamIdentificationItem></teamIdentificationItem><teamsLeaderBoard>5</teamsLeaderBoard><teamName1></teamName1><teamName2></teamName2><teamName3></teamName3><teamName4></teamName4><teamName5></teamName5><teamName6></teamName6><teamName7></teamName7><teamName8></teamName8><teamName9></teamName9><teamName10></teamName10><showControlBar>All Slides</showControlBar><defaultCorrectPointValue>0</defaultCorrectPointValue><defaultIncorrectPointValue>0</defaultIncorrectPointValue><chartColor1>187,224,227</chartColor1><chartColor2>51,51,153</chartColor2><chartColor3>0,153,153</chartColor3><chartColor4>153,204,0</chartColor4><chartColor5>128,128,128</chartColor5><chartColor6>0,0,0</chartColor6><chartColor7>0,102,204</chartColor7><chartColor8>204,204,255</chartColor8><chartColor9>255,0,0</chartColor9><chartColor10>255,255,0</chartColor10><teamColor1>187,224,227</teamColor1><teamColor2>51,51,153</teamColor2><teamColor3>0,153,153</teamColor3><teamColor4>153,204,0</teamColor4><teamColor5>128,128,128</teamColor5><teamColor6>0,0,0</teamColor6><teamColor7>0,102,204</teamColor7><teamColor8>204,204,255</teamColor8><teamColor9>255,0,0</teamColor9><teamColor10>255,255,0</teamColor10><displayAnswerImagesDuringVote>Yes</displayAnswerImagesDuringVote><displayAnswerImagesWithResponses>Yes</displayAnswerImagesWithResponses><displayAnswerTextDuringVote>Yes</displayAnswerTextDuringVote><displayAnswerTextWithResponses>Yes</displayAnswerTextWithResponses><questionSlideID></questionSlideID><controlBarState>Expanded</controlBarState><isGridColorKnownColor>True</isGridColorKnownColor><gridColorName>Yellow</gridColorName></Settings> <?xml version="1.0"?><AllAnswers /> MSK Case Presentation David Stone May 22, 2008

  2. 19 yo Lacrosse Player • ~2 weeks ago, he was hit in his quadricep with a lacrosse stick. • Initial injury has improved some, but are has remained tender. • He returned to the field after 5 days. • Presents with pain, tenderness, warmth, focal swelling of his thigh. • New Development: He can palpate a new “lump” in the leg.

  3. Myositis Ossificans • Heterotopic bone formation in muscle in the setting of trauma. • Injury: Compression of muscle tissue against underlying bone with injury to the muscle, blood vessels, and periostium. • Seen radiographically about 2-4 weeks after initial hematoma.

  4. Myositis Ossificans • Bone will begin to grow 2-4 weeks after the injury and mature bone will be seen by 3-6 months. • Most common in athletic adults in the 2nd or 3rd decade • Usually in the setting of trauma. • Most common locations: Quadriceps, Brachialis, Deltoid.

  5. Myositis Ossificans • Why do some develop this lesion? • Not applying ice and compression immediately after the injury. • Intensive physiotherapy, massage, or heat too soon after the injury. • Returning to play too soon after injury.

  6. Major Differential Diagnosis • Osteosarcoma • Sunburst Appearance

  7. Radiological Comparison • Myositis ossificans • Calcification begins at the periphery and progresses toward the center. • Radiographic stabilization or improvement at 3 to 4 months • Osteosarcoma • Calcification begins at the center and progresses to the periphery. • Continued radiographic growth

  8. Clinical Comparison • Myositis Ossificans is favored with: • History of trauma to the affected site • Clinical improvement at 3 to 4 months • Most Important: Pain lessens with time • Pain with osteosarcoma is progressive and unrelenting.

  9. Myositis Ossificans • Treatment: Conservative • Rest, Immobilization, Ice • Things that decrease initial hematoma • Will usually resolve on its own • Surgery: Rarely indicated • Only if it interferes with joint movement or it irritates a nerve. • Usually wait 12 months for lesion to mature as shown by bone scan. • If removed before mature, it will likely recur

  10. References • Essentials of Physical Medicine and Rehabilitation, 1st edition • DeLee and Drez’s Orthopedic Sports Medicine, 2nd edition • www.bonetumor.org

More Related