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A 33-year-old man sustained a severe spinal cord injury at the T10 level during a motor vehicle accident. During a prolonged rehabilitation with immobilization for healing of multiple fractures, he developed hip pain and decreased range of motion. Examination shows tender, warm nodular areas in the region around each hip. Plain films show calcifications within the soft tissues around his hip joints. Which of the following is a likely complication of his spinal cord injury represented by these findings?
Explanation
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This presentation of hip pain with decreased range of motion, tender warm regions, and calcifications in soft tissues around the joint are consistent with the development of heterotopic ossification. Large joints below the level of injury such as the hip are affected. This complication occurs in up to 50%of traumatic spinal cord injury patients, but is much less common in nontraumatic myelopathies. A triple-phase bone scan is the best diagnostic test.
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Reference
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Page 193 Abrams GM, Ganguly K. Management of chronic spinal cord dysfunction. Continuum (Minneap Minn). 2015 Feb;21(1 Spinal Cord Disorders):188-200. doi: 10.1212/01.CON.0000461092.86865.a4. PMID: 25651225; PMCID: PMC4325904.
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Option 1
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Is Correct (Option 1):
Bursitis
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Option 2
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Is Correct (Option 2):
Thrombophlebitis
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Option 3
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Is Correct (Option 3):
Heterotopic ossification
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Option 4
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Is Correct (Option 4):
Osteoarthritis
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