Presentation
We present an unusual presentation of POH in a 7-year-old female child. The clinical features included a painful swelling on the left foot, with mechanical complaints. There was no congenital hallux valgus. [ncbi.nlm.nih.gov]
[Error: Macro 'ref' doesn't exist] Clinical Findings Progressive osseous heteroplasia (POH) presents in early childhood with cutaneous ossifications. [moldiag.com]
Presenting problem: We present an unusual presentation of POH in a 7-year-old female child. The clinical features included a painful swelling on the left heel, with mechanical complaints. There was no congenital hallux valgus. [bone-abstracts.org]
Entire Body System
- Pain
Case 3: A 9-year-old boy with knee pain and subcutaneous ossifications in back and upper/lower extremity, causing significantly limited joint mobility. Lab tests were normal. [ncbi.nlm.nih.gov]
Pain Book appointment and get ₹125 LybrateCash (Lybrate Wallet) after your visit Dr. [lybrate.com]
It may cause pain and the development of open sores (ulcers) in affected areas of the body. Joints may become involved over time, causing impaired mobility. [rareguru.com]
They may cause pain and swelling, stiffness in the joints, all-around discomfort, and a low-grade fever. Continued Complications The condition may cause chronic (ongoing) swelling nearly anywhere in your body. [webmd.com]
Our patient is on treatment for chronic pain. Written informed patient consent for publication has been obtained. [eurorad.org]
- Developmental Disorder
Progressive osseous heteroplasia is a rare developmental disorder of mesenchymal differentiation characterized by cutaneous osteomas in infancy and by progressive heterotopic intramembranous ossification of skin and deep connective tissue. [ncbi.nlm.nih.gov]
disorder of heterotopic ossification. [genome.jp]
@inproceedings{Macewen2006TwoNC, title={Two new case reports and follow-up of three Progressive osseous heteroplasia : a distinct developmental disorder of}, author={G. [semanticscholar.org]
Progressive osseous heteroplasia: a distinct developmental disorder of heterotopic ossification. [jpeds.com]
- Swelling
The skin over the swellings was fixed and normal in temperature. Movements at shoulder, elbow, and wrist were grossly restricted. [ijoonline.com]
The disorder can be distinguished from fibrodysplasia ossificans progressiva (FOP) by the presence of cutaneous ossification, the absence of congenital malformations of the skeleton, the absence of inflammatory tumorlike swellings, the asymmetric mosaic [ncbi.nlm.nih.gov]
They may cause pain and swelling, stiffness in the joints, all-around discomfort, and a low-grade fever. Continued Complications The condition may cause chronic (ongoing) swelling nearly anywhere in your body. [webmd.com]
The clinical features included a painful swelling on the left foot, with mechanical complaints. There was no congenital hallux valgus. Family anamnesis was positive in the father. [cris.maastrichtuniversity.nl]
- Disability
Progressive osseous heteroplasia (POH) is a rare, disabling disease of heterotopic ossification (HO) that progresses from skin and subcutaneous tissues into deep skeletal muscle. [ncbi.nlm.nih.gov]
disability, Cilliers type X-linked intellectual disability, Golabi-Ito-Hall type X-linked intellectual disability, Gu type X-linked intellectual disability, Hedera type X-linked intellectual disability, Miles-Carpenter type X-linked intellectual disability [se-atlas.de]
Part A 2008 July 15, 146A (14): 1788-96 18553568 Progressive osseous heteroplasia (POH) is a rare, disabling disease of heterotopic ossification (HO) that progresses from skin and subcutaneous tissues into deep skeletal muscle. [read.qxmd.com]
Format Definition Rare autosomal dominant disorder characterized by extensive dermal ossification during childhood, followed by disabling and widespread heterotopic ossification of skeletal muscle and deep connective tissue. [uniprot.org]
- Surgical Procedure
These include: Genetic conditions (such as fibrodysplasia ossificans progressiva and progressive osseous heteroplasia) Surgical procedures (including total hip replacement, elbow fracture, and forearm fracture surgery) Brain or spinal cord injury (traumatic [verywell.com]
Skin
- Ulcer
It may cause pain and the development of open sores (ulcers) in affected areas of the body. Joints may become involved over time, causing impaired mobility. [rareguru.com]
(cutaneous) ossification, which progresses to involvement of subcutaneous and deep tissues, including muscle. [1] [2] In some cases, it first becomes apparent later in childhood or in early adulthood. [1] Ossification may cause pain and open sores (ulcers [rarediseases.info.nih.gov]
The bony lesions within the skin may be painful and may develop into open sores (ulcers). Over time, joints can become involved, resulting in impaired mobility. [encyclopedia.pub]
- Calcinosis Cutis
Biopsy results from the lesions showed calcinosis cutis superficially, with both endochondral and intramembranous bone formation in the deeper tissues. [ncbi.nlm.nih.gov]
- Eruptions
Phototoxic and photoallergic reactions + Berloque dermatitis + Syndrome Favre-Racouchot + Actinic damage of the skin + Metabolic and nutrition problems + Pellagra + Rachitis, avitaminosis D + Scorbut, avitaminosis C + Drug reactions + Lichenoid drug eruptions [atlases.muni.cz]
Musculoskeletal
- Ankylosis
Extensive ossification of the deep connective tissues results in ankylosis of affected joints and growth retardation of involved limbs[1]. Bone scintigraphy shows pathological increase uptake in the regions of calcified soft tissue. [eurorad.org]
Unfortunately, amputations are sometimes needed when there is severe growth retardation and functional ankylosis (locking of joints). [rareguru.com]
Extensive ossification of the deep connective tissues results in ankylosis of affected joints and focal growth retardation of involved limbs. [ifopa.org]
[…] rez de Nanclares G 2017 4 Progressive osseous heteroplasia is not a Mendelian trait but a type 2 segmental manifestation of GNAS inactivation disorders: A hypothesis. ( 27058263 ) Happle R. 2016 5 Total Ankylosis of the Upper Left Limb: A Case of Progressive [malacards.org]
- Myopathy
Charcot-Marie-Tooth disease type 3 X-linked Charcot-Marie-Tooth disease type 4 X-linked Charcot-Marie-Tooth disease type 5 X-linked Charcot-Marie-Tooth disease type 6 X-linked Opitz G/BBB syndrome X-linked calvarial hyperostosis X-linked centronuclear myopathy [se-atlas.de]
Psychiatrical
- Suggestibility
Occasional reports of mild heterotopic ossification in Albright's hereditary osteodystrophy (AHO) and a recent report of two patients with AHO who had atypically extensive heterotopic ossification suggested a common genetic basis for the two disorders [ncbi.nlm.nih.gov]
Neurologic
- Irritability
Since bone in POH often involves the skin, a bump or fall can cause an irritation of the skin at the site of the bump. This can sometimes cause the bone in the skin to break through the surface of the skin. [fopfriends.com]
Subcutaneous ossifications that are superficial and well circumscribed may be surgically removed when they are large or cause local irritation, although they may recur [2]. [gulfdoctor.net]
dermatitis, acute + Toxic contact (irritative) dermatitis, chronic + Seborrhoic dermatitis + Pityriasis amiantacea + Changes caused by rubbing, scratching and pressure + Lichen simplex + Strophulus + Prurigo gestationis + Prurigo nodularis + Prurigo [atlases.muni.cz]
Children with osteoma cutis or POH may also have sharp, needle-like projections of bone (spicules) that break through the surface of the skin, causing irritation or superficial infection. [rarediseases.org]
- Confusion
[…] proliferation with reactive bone formation 50% have history of trauma, although often trivial Rapid growth May occur in hand (called florid reactive periostitis, fibroosseous tumor of digits, parosteal fasciitis) Rarely associated with malignancy, but may be confused [pathologyoutlines.com]
NHHO presents as a painful soft tissue mass, which can be easily confused with malignant lesions such as osteosarcoma and soft tissue sarcoma. [14] Diagnosis of this condition may be difficult and requires radiological or histological findings after genetic [emedicine.medscape.com]
[…] gender or geographic prediliction. 5 1.10 Diagnostic setting: Comment: ad A: To differentiate from other forms of heterotopic ossification (different forms of myositis ossificans (MO), progressive osseous heteroplasia (POH) or other forms that might be confused [nature.com]
Treatment
Jwalant Modi MS - Orthopaedics, MBBS Orthopedist - Specializes in Treatment of Progressive Osseous Heteroplasia modi hospital near samarpan tower kk nagar road prabhat chowk Ghaltodia, Ahmedabad Recently consulted for: Knee Pain, Knee Pain Treatment Book [lybrate.com]
There are two main types of clinical studies: Clinical trials determine if a new test or treatment for a disease is effective and safe by comparing groups receiving different tests/treatments. [rarediseases.info.nih.gov]
Make the best clinical decisions with an enhanced emphasis on evidence-based practice and expert opinions on treatment strategies. Zero in on the most relevant and useful references with the aid of a more focused, concise bibliography. [books.google.com]
Another controversial treatment is the use of radiation treatment in a single dose to alter the cells that produce the excess bone formation. [verywell.com]
Chronogram depicting treatments received and evolution of the disease in the first twin. [frontiersin.org]
Prognosis
The genetics, diagnostic criteria, supporting clinical features, current management, and prognosis of POH are reviewed here, and emerging therapeutic strategies are discussed. [go.gale.com]
The patient was advised physiotherapy to maintain range of motion and the parents were counseled regarding the prognosis of the disease. [ijoonline.com]
Prognosis - Progressive osseous heteroplasia Not supplied. Treatment - Progressive osseous heteroplasia Not supplied. Resources - Progressive osseous heteroplasia Not supplied. [checkorphan.org]
Etiology
ETIOLOGY/EPIDEMIOLOGY: The disorder may be sporadic or familial. Offspring of affected individuals inherit the disease in an autosomal dominant manner with widely variable expression. Males and females are affected equally. [ifopa.org]
Exclusion of genetic etiologies, based on older age at presentation alone, should be carefully considered. [mayoclinic.org]
There are many etiologies that are included in the differential diagnosis of heterotopic ossification. Giant osteoma plates were not seen radiologically. [jpeds.com]
多発性嚢胞腎 Polycystic Kidney disease, unknown genetic etiology 多発性嚢胞腎、遺伝子型不明 1 不要 有 HPS1264 HPS1265 HPS1266 HPS1267 HPS1268 HPS1269 Polycystic Kidney disease (ADPKD) 常染色体優性多発性嚢胞腎 1 不要 有 HPS2192 HPS2193 HPS2194 HPS2195 HPS2196 HPS2197 2 不要 有 HPS2636 HPS2637 [cell.brc.riken.jp]
Epidemiology
ETIOLOGY/EPIDEMIOLOGY: The disorder may be sporadic or familial. Offspring of affected individuals inherit the disease in an autosomal dominant manner with widely variable expression. Males and females are affected equally. [ifopa.org]
Epidemiology FOP is very rare with a worldwide prevalence of approximately 1 case in 2 million individuals. No ethnic, racial, or geographic predisposition has been described [ 2 ]. [ojrd.biomedcentral.com]
Pathophysiology
[…] in humans, to the discovery of progressive osseous heteroplasia (another disorder of heterotopic ossification) and its causative gene and pathophysiology. [med.upenn.edu]
Michael Zasloff, provided the stimulus for his long-held interest in probing the molecular pathophysiology of skeletal disorders. [joshuasfop.com]
The investigation of relevant cells and microenvironmental factors is necessary to elucidate the complex pathophysiology of FOP. [ojrd.biomedcentral.com]
Acutely After Elbow Trauma Terminated NCT00991887 37 Study Into the Effect of Pamidronate for the Prevention of Heterotopic Ossification in High-risk Patients: A Randomized Controlled Trial Withdrawn NCT00262392 Pamidronate (AREDIA) 38 Defining the Pathophysiology [malacards.org]
Prevention
At this time, there are no effective treatments or prevention for progressive osseous heteroplasia (POH). [rareguru.com]
Prevention In patients at high risk for the development of heterotopic bone formation, there are several treatments that have been used to prevent the development of excess bone. [verywell.com]
Banovac K, Williams JM, Patrick LD, Haniff YM (2001) Prevention of heterotopic ossification after spinal cord injury with indomethacin. Spinal Cord 39: 370–374 PubMed CrossRef Google Scholar 2. [link.springer.com]
Prevention - Progressive osseous heteroplasia Not supplied. Diagnosis - Progressive osseous heteroplasia signs and symptoms of Progressive Osseous Heteroplasia may vary on an individual basis for each patient. [checkorphan.org]
Its use in the prevention of HO after hip arthroplasty (17) and spinal cord injury (SCI) (32) is well-established. On the other hand, evidence for this therapeutic approach for flare-up prevention in FOP is lacking (26). [frontiersin.org]