Heterotopic Ossifications in patients with spine injury: an appropriate multidisciplinary diagnostic approach and the radiographer's role for the optimization of technical procedures.

Congress:

ECR 2020

Poster Number:

C-05704

Type:

Educational Exhibit

Keywords:

Performed at one institution, Observational, Retrospective, Education and training, Connective tissue disorders, Diagnostic procedure, CT, Conventional radiography, Musculoskeletal system, Musculoskeletal soft tissue, Musculoskeletal joint, Professional Issues

Authors:

M. BERTOLI¹, B. Musso²; ¹Torino/IT, ²Turin/IT

DOI:

10.26044/ecr2020/C-05704

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-05704

Fig. 1: 3D CT of extended HO to the coxo-femoral joints

Fig. 2: surgical finding in resection of hip HO

Background

Heterotopic ossification (HO) is the formation of pathological bone in muscle or soft tissue. The incidence in individuals following a spinal cord injury has been reported to vary greatly (from 10% to 78%).

HO occurs below the level of paralysis and most commonly forms in the hip but rarely in the peripheral joints such as the shoulders, elbows, and knees.

Associated risk factors are completeness of injury, previous mechanical ventilation often associated with thoracic trauma.

Surgical resection of HO post-SCI is a well-established treatment but is still somewhat controversial. (fig. 2)

[from Spinal Cord Injury Research Evidence (SCIRE) Project]

Diagnostic protocols have been defined according to a multidisciplinary approach on the basis of scientific evidence and our experience at the Turin’s Trauma Center and Spinal Unit.

Conventional Radiology: proposal of a diagnostic protocol with dedicated x-ray projections.

Computed Tomography is the "gold standard" exam and in this study, is presented a low-dose protocol that includes MPR sequences and 3D reconstructions.

Nuclear Medicine and MR have an important role in terms of predictivity; however, MR's contribution is lower: for both methods, are indicated specific protocols for HO.