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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Injured lower calf, haematoma formed, hard area. Taken decadron injections. Symptoms of Myositis Ossificans?

I fell several years ago and my lower calf landed on some large rocks. I had a HUGE hematoma , which finally went away, but has left a fairly large HARD area. My PCP at the time gave me a couple of injections of Decadron.... It has started to hurt continually, even when just sitting. While trying to walk on the treadmill or elliptical, the pain is almost excrutiating. Do I have Myositis Ossificans and what can be done about it ?
Mon, 22 Jul 2013
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi, thanks for writing to HCM.

MYOSITIS OSSIFICATION in your case is a strong possibility. The points that favour this diagnosis in your case are
* History of blunt trauma
* formation of a large hematoma after the injury
* Palpable HARD mass in the injured site after few months

ONE IMPORTANT POINT TO MENTION HERE- WHEN AN XRAY IS TAKEN, A MYOSITIS MASS MOST OFTEN RESEMBLES "OSTEOSARCOMA" (malignant bone tumour) IN APPEARANCE. So a history of previous trauma always indicates myositis ossificans and not osteosarcoma.

No treatment is generally needed if the myositis mass is not painful or is not causing obstruction to the joint movements.

The standard teaching is that myositis mass should not be resected untill a MATURE bone is formed which usually takes around 18-24 months. So this should never be removed within 2 years of formation as it tends to recur in the same place again.

After excision of the myositis mass, recurrence is prevented by giving INDOMETHACIN 75MG daily for 6 weeks post operatively or radiation of 750 Gy locally.

Hope this information is helpful. Good day
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Injured lower calf, haematoma formed, hard area. Taken decadron injections. Symptoms of Myositis Ossificans?

Hi, thanks for writing to HCM. MYOSITIS OSSIFICATION in your case is a strong possibility. The points that favour this diagnosis in your case are * History of blunt trauma * formation of a large hematoma after the injury * Palpable HARD mass in the injured site after few months ONE IMPORTANT POINT TO MENTION HERE- WHEN AN XRAY IS TAKEN, A MYOSITIS MASS MOST OFTEN RESEMBLES OSTEOSARCOMA (malignant bone tumour) IN APPEARANCE. So a history of previous trauma always indicates myositis ossificans and not osteosarcoma. No treatment is generally needed if the myositis mass is not painful or is not causing obstruction to the joint movements. The standard teaching is that myositis mass should not be resected untill a MATURE bone is formed which usually takes around 18-24 months. So this should never be removed within 2 years of formation as it tends to recur in the same place again. After excision of the myositis mass, recurrence is prevented by giving INDOMETHACIN 75MG daily for 6 weeks post operatively or radiation of 750 Gy locally. Hope this information is helpful. Good day