Journal of Orthopaedic Case Reports最新文献

{"title":"Comparative Study of Effect of Periarticular Fentanyl and Dexmedetomidine Injection for Pain Management in Total Knee Arthroplasty a Randomized Control Trial.","authors":"Ayush Sharma, Amit Saraf, Mukesh Kumar Prasad, Mayank Phogaat, Sahil Shah, Shubham Jain","doi":"10.13107/jocr.2026.v16.i10.8334","DOIUrl":"10.13107/jocr.2026.v16.i10.8334","url":null,"abstract":"<p><strong>Introduction: </strong>Post-operative pain following total knee arthroplasty (TKA) remains a major challenge and may delay rehabilitation, ambulation, and functional recovery. Periarticular infiltration analgesia has emerged as an effective component of multimodal pain management protocols. Dexmedetomidine and fentanyl are commonly used analgesic adjuvants; however, comparative evidence regarding their periarticular use in TKA remains limited.</p><p><strong>Objectives: </strong>The aim of the study was to compare the analgesic efficacy of periarticular fentanyl and dexmedetomidine injection in patients undergoing TKA by evaluating post-operative pain relief, duration of analgesia, cumulative analgesic requirement, time to ambulation, and duration of hospital stay following surgery.</p><p><strong>Materials and methods: </strong>This prospective hospital-based randomized controlled trial was conducted in the Department of Orthopaedics at Teerthanker Mahaveer Medical College and Research Centre over 18 months. A total of 90 patients undergoing TKA were randomly allocated into three groups comprising 30 patients each: Group A (Bupivacaine + Fentanyl), Group B (Bupivacaine + Dexmedetomidine), and Group C (Bupivacaine + Saline). Post-operative pain was assessed using the Visual Analog Scale. Cumulative analgesic requirement, ambulation time, hospital stay, and post-operative morbidity scores were also evaluated. Appropriate statistical tests and multiple linear regression analysis were applied.</p><p><strong>Results: </strong>Patients receiving periarticular dexmedetomidine demonstrated significantly lower post-operative pain scores at 6 h (5.63 ± 1.06) compared with fentanyl (6.50 ± 1.10) and saline groups (7.23 ± 1.22) (P = 0.021). The dexmedetomidine group also showed the lowest cumulative post-operative diclofenac requirement (597.50 ± 153.17 mg) compared with the fentanyl (680.00 ± 132.02 mg) and saline groups (758.33 ± 109.13 mg) (P = 0.001). Regression analysis identified dexmedetomidine as an independent predictor of reduced post-operative analgesic requirement (β = -102.4, P = 0.001).</p><p><strong>Conclusion: </strong>Periarticular dexmedetomidine infiltration provided superior post-operative analgesia, reduced cumulative analgesic consumption, and improved post-operative recovery following TKA compared with fentanyl and saline infiltration.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"535-541"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed Metachronous Multicentric Giant Cell Tumor of Bone after a 16-Year Disease-Free Interval: A Case Report.","authors":"Dilip Kumar Sankhwar, Puneet Yadav, Asit Ranjan Mridha, Jaiben George, Vivek Shankar, Venkatesan Sampath Kumar","doi":"10.13107/jocr.2026.v16.i10.8272","DOIUrl":"10.13107/jocr.2026.v16.i10.8272","url":null,"abstract":"<p><strong>Introduction: </strong>Multicentric giant cell tumor (GCT) of bone is rare and usually occurs synchronously or within a few years of the primary lesion. Delayed metachronous presentation is exceedingly uncommon.</p><p><strong>Case report: </strong>We present the case of a 48-year-old man with progressive left hip pain 16 years after wide resection and endoprosthetic reconstruction for GCT of the proximal right humerus. Imaging demonstrated well-defined lytic lesions involving the bilateral proximal femur, left iliac bones, with cortical breach in the periacetabular region and right iliac bone. Whole-body positron emission tomography computed tomography revealed no additional skeletal lesions or pulmonary metastases, and core needle biopsy confirmed GCT. Metabolic evaluation, including serum parathyroid hormone levels, was normal, excluding hyperparathyroidism-related brown tumors. Given the multicentric involvement of the bilateral pelvis and proximal femur, the anatomically complex periarticular location of the lesions, and the substantial morbidity associated with extensive surgical resection and reconstruction, a non-operative treatment strategy was considered more appropriate. The patient was therefore treated with six intravenous zoledronic acid infusions at monthly intervals.</p><p><strong>Conclusion: </strong>There is achieved complete pain relief, returned to unrestricted functional activity, and demonstrated radiological stabilization with progressive sclerosis and no disease progression at 4-year follow-up. This case highlights the unpredictable biological behavior of GCT, the possibility of very late metachronous multicentric disease, and the potential role of bisphosphonate monotherapy as a limb-preserving treatment option in carefully selected patients.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"297-301"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Blood Flow Restriction Therapy as an Adjunct to Standard Rehabilitation Following Anterior Cruciate Ligament Reconstruction: A Prospective Observational Cohort Study.","authors":"Happy Gahlawat, Jaswant Kumar, Amit Hegde, Prashant Sharma, Himanshu Gupta, Deepak Joshi","doi":"10.13107/jocr.2026.v16.i10.8322","DOIUrl":"10.13107/jocr.2026.v16.i10.8322","url":null,"abstract":"<p><strong>Introduction: </strong>Quadriceps weakness and muscle atrophy remain major challenges following anterior cruciate ligament (ACL) reconstruction. Blood flow restriction (BFR) therapy enables low-load resistance training and may enhance early rehabilitation outcomes. This study evaluated the clinical and radiological outcomes of adding BFR therapy to standard post-operative rehabilitation.</p><p><strong>Materials and methods: </strong>In this prospective observational cohort study, 40 patients (18-45 years) undergoing arthroscopic ACL reconstruction received standard rehabilitation supplemented with BFR therapy (60-80% limb occlusion pressure) from post-operative day 1 for 16 weeks. The primary outcome was quadriceps cross-sectional area (CSA) on magnetic resonance imaging. Secondary outcomes included Numeric Pain Rating Scale (NPRS), thigh girth, and Lysholm score. Paired t-tests were used for analysis.</p><p><strong>Results: </strong>Mean age was 28.25 ± 7.15 years, with 90% male. NPRS increased on post-operative day 1 (P < 0.0001) and significantly decreased thereafter (P ≤ 0.001). Lysholm scores improved from 70.57 ± 7.37 to 88.82 ± 5.38 (P < 0.0001), exceeding the minimal clinically important difference. Thigh girth remained unchanged (P > 0.05). Quadriceps CSA showed a non-significant reduction (approximately 6%; P = 0.123).</p><p><strong>Conclusion: </strong>BFR therapy is a safe and well-tolerated adjunct to standard ACL rehabilitation, associated with improved functional outcomes and pain while preserving muscle mass. Larger randomized controlled trials with longer follow-up are required to validate these findings.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"485-492"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Functional Outcome of Closed Intra-articular Fracture of Proximal Interphalangeal Joint of Hand Managed By Suzuki Frame - A Longitudinal Study.","authors":"S Balaji, Arun Kaliaperumal, C Gokulraj, Rumesh Kannan Gunasekaran, R Muralidharan, Avinash Gogoularadja","doi":"10.13107/jocr.2026.v16.i10.8306","DOIUrl":"10.13107/jocr.2026.v16.i10.8306","url":null,"abstract":"<p><strong>Introduction: </strong>Closed intra-articular fractures of the proximal interphalangeal (PIP) joint are difficult to manage because of the small articular surface, joint instability, and risk of post-operative stiffness. Dynamic external fixation using the Suzuki frame aims to restore joint congruity while permitting early mobilization and functional recovery.</p><p><strong>Aim: </strong>This study aims to evaluate the functional outcomes of closed intra-articular PIP joint fractures of the hand managed with Suzuki frame fixation.</p><p><strong>Materials and methods: </strong>This prospective study included 32 patients with closed intra-articular PIP joint fractures treated using the Suzuki dynamic external fixation frame. One patient was lost to follow-up; therefore, 31 patients were included in the functional outcome analysis. Patients were followed for 12 weeks. Functional outcomes were assessed using PIP joint range of motion (ROM), quick disabilities of the arm, shoulder, and hand (QuickDASH) score, and post-operative complications.</p><p><strong>Results: </strong>The majority of patients were male (78.1%) aged 17-30 years (56.3%). Slip and fall (43.8%) was the most common mechanism of injury. Mean ROM improved significantly from 42.5° ± 8.3° at 6 weeks to 110.6° ± 9.2° at 12 weeks (P < 0.001). The mean QuickDASH score improved from 99.0 ± 0.0 at 6 weeks to 14.9 ± 4.5 at 12 weeks (P < 0.001). Most patients (81.3%) had no post-operative complications, with only one case each of extensor lag and non-union, and no pin-tract infection or joint instability.</p><p><strong>Conclusion: </strong>Suzuki frame fixation provides excellent short-term functional recovery in closed intra-articular PIP joint fractures by allowing early mobilization, restoring joint motion, and maintaining low complication rates. It is a safe, minimally invasive, and effective treatment option for unstable PIP joint fractures.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"423-430"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant Cell Tumor of the Distal Phalanx of the Great Toe: Case Report.","authors":"Evani Anirudh Sarma, Mantu Jain, Harshit Mishra, A Muhammad Zainul Aabid, Shahnawaz Khan, Jagatjyoti Panda","doi":"10.13107/jocr.2026.v16.i10.8184","DOIUrl":"10.13107/jocr.2026.v16.i10.8184","url":null,"abstract":"<p><strong>Introduction: </strong>Giant cell tumor (GCT) of bone is a benign but locally aggressive neoplasm that most commonly involves the epiphyseal-metaphyseal regions of long bones. Involvement of the foot is rare, and occurrence in the distal phalanx of the great toe is exceptionally uncommon. GCTs arising in small bones are known to exhibit more aggressive behavior and higher recurrence rates than those in long bones, posing challenges for management.</p><p><strong>Case report: </strong>We report the case of a young adult presenting with progressive pain and swelling of the great toe. Radiographs and magnetic resonance imaging demonstrated an expansile osteolytic lesion of the distal phalanx with cortical destruction and soft-tissue extension. Histopathological examination following open biopsy confirmed the diagnosis of GCT of bone. The patient received three doses of denosumab, followed by surgical resection of the distal phalanx with the intent of limb preservation. The post-operative course was uneventful. At the 1-year follow-up, the patient remains symptom-free, with no evidence of recurrence.</p><p><strong>Conclusion: </strong>GCT of the distal phalanx of the great toe is a rare entity with aggressive local behavior. Early diagnosis, histopathological confirmation, and appropriate surgical planning are essential for achieving local control. Limb-preserving strategies can be considered in selected cases, but vigilant follow-up is mandatory due to the high risk of recurrence.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"52-56"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Surgical Escalation and Structured Multidisciplinary Pathways Improve Limb-Salvage Outcomes in Necrotizing Fasciitis: A Two-Cycle Quality Improvement Project.","authors":"Aakaash Venkatesan, Mahal Baid, Omar-Aldoori, Mohammed Abdalla","doi":"10.13107/jocr.2026.v16.i10.8348","DOIUrl":"10.13107/jocr.2026.v16.i10.8348","url":null,"abstract":"<p><strong>Introduction: </strong>Necrotizing fasciitis (NF) is a rapidly progressive, life-threatening soft-tissue infection characterized by extensive fascial necrosis and systemic toxicity. Reported mortality ranges from 20% to 40%, driven largely by diagnostic delay. Orthopedic units carry a disproportionate burden, particularly for lower-limb disease. This two-cycle quality improvement project (QIP) examined whether structured diagnostic pathways and early multidisciplinary escalation could reduce time to surgery and improve limb-salvage outcomes.</p><p><strong>Case series: </strong>Twenty-seven patients with confirmed or suspected NF were managed across two sequential audit cycles at a tertiary orthopedic center (Cycle 1, n = 14; Cycle 2, n = 13). Mean age was 52.1 ± 11.3 years; 80% had lower-limb involvement, and 70% had diabetes mellitus. Following QIP implementation, median time to surgical decision fell from 11.5 ± 3.2 to 6.8 ± 2.1 hours (P = 0.002). Recovery rates rose from 14.3% to 84.6% (P < 0.001) and major amputation rates declined from 35.7% to 15.4% (P = 0.04). Documentation of Laboratory Risk Indicator for Necrotizing Fasciitis scores and finger-sweep testing improved significantly. In-hospital mortality remained comparable (21.4% vs. 23.1%).</p><p><strong>Conclusion: </strong>A structured, protocol-driven approach to NF management - encompassing mandatory diagnostic documentation, early senior involvement, and multidisciplinary team activation - substantially improves surgical timeliness and limb-salvage rates. Mortality reduction may require parallel optimization of perioperative sepsis management and critical care pathways.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"599-605"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Medial Medullary Syndrome Following Anterior Odontoid Screw Fixation for a Type II Fracture: A Case Report.","authors":"Sharath Raj, Deepak Kumar, Vishal Kumar, Aashish Kumar Sen, Saloni Rani Kumar, Vijay G Goni","doi":"10.13107/jocr.2026.v16.i10.8256","DOIUrl":"10.13107/jocr.2026.v16.i10.8256","url":null,"abstract":"<p><strong>Introduction: </strong>Medial medullary syndrome is an uncommon brainstem stroke, and bilateral involvement is rarer still. It has not, to our knowledge, been described as a complication of anterior screw fixation for a type II odontoid fracture.</p><p><strong>Case report: </strong>A 28-year-old man sustained a posteriorly displaced type II odontoid fracture with an associated C2 spinous process fracture in a road traffic accident. He was neurologically intact at admission. Surgery was briefly postponed after a transient episode of anisocoria during induction that resolved without deficit and with a normal computed tomography (CT) angiogram. Halo-ring traction was applied preoperatively for 3 days to achieve gradual fracture reduction, and anterior fixation with two cannulated lag screws was performed uneventfully. Weaning from ventilation was prolonged and complicated; cerebral CT was unremarkable, but magnetic resonance imaging (MRI) showed acute bilateral medial medullary ischemia. He developed a bilateral incomplete tetraparesis, predominantly left-sided, with pyramidal signs and a right hypoglossal palsy (American Spinal Injury Association [ASIA] C)]. Tracheostomy, gastrostomy feeding, anticoagulation, antiplatelet therapy, and early rehabilitation were instituted. Severe atherosclerosis of the bilateral vertebral and basilar arteries, in a patient with hypertension, dyslipidemia, and long-standing smoking, was the only etiological factor identified. At 6-month follow-up, he had improved to ASIA D and was ambulating short distances with a cane.</p><p><strong>Conclusion: </strong>Postoperative brainstem ischemia should be suspected whenever weaning fails or new deficits appear after upper cervical spine surgery, even with a normal CT; MRI with diffusion-weighted sequences is required to confirm the diagnosis. Perioperative manipulation of the cervical spine in a patient with underlying atherosclerosis may be an under-recognized mechanism for this rare complication.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"252-259"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic Piecemeal Excision of a Large Intra-articular Infrapatellar Osteochondroma of the Knee: A Case Report.","authors":"Nazmuddin Jetaji, Sara Sami, Rajan Babu, Sreekanth Reddy Rajoli","doi":"10.13107/jocr.2026.v16.i10.8206","DOIUrl":"10.13107/jocr.2026.v16.i10.8206","url":null,"abstract":"<p><strong>Introduction: </strong>Intra-articular osteochondromas are uncommon mass-occupying lesions of the knee, with a reported prevalence of approximately 1 in 1 million. Large lesions in the infrapatellar region are exceptionally rare, and only a handful of cases have been described in the literature. Based on a comprehensive review of the English literature, to the best of our knowledge, we report what appears to be one of the largest intra-articular infrapatellar osteochondromas successfully excised using a minimally invasive arthroscopic technique.</p><p><strong>Case report: </strong>A 46-year-old Filipino female presented with a 6-month history of progressive pain, swelling, and restriction of motion in the left knee. Imaging revealed a well-defined ossified mass in the infrapatellar region measuring approximately 28 × 20 mm - comparable in size to the native patella. The lesion was excised arthroscopically in a piecemeal fashion followed by retrieval through a mini-open medial parapatellar incision. Histopathological examination confirmed the diagnosis of an osteochondroma with a hyaline cartilaginous cap.</p><p><strong>Conclusion: </strong>This case demonstrates that large intra-articular osteochondromas of the infrapatellar region, though rare, can be safely and effectively managed with arthroscopic piecemeal excision, facilitating early rehabilitation and avoiding the morbidity of open surgery. The presence or absence of synovial tissue within the lesion helps determine the etiology and malignant potential, although transformation remains rare.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"113-119"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not All Pedicle Violations Are Equal: Defining Breach, Miss, Break, and Burst and Their Salvage Strategies.","authors":"Shailesh Hadgaonkar, Jaspal Khushalsingh Pardeshi, Diptesh Jadhav, Ashok Shyam","doi":"10.13107/jocr.2026.v16.i10.8164","DOIUrl":"10.13107/jocr.2026.v16.i10.8164","url":null,"abstract":"","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myositis Ossificans Affecting the Rotator Cuff Muscles and Proximal Humerus: A Rare Clinical Entity.","authors":"Saqib Yasin, Mayank Rajput, Kasukurthi Leelakanth","doi":"10.13107/jocr.2026.v16.i10.8192","DOIUrl":"10.13107/jocr.2026.v16.i10.8192","url":null,"abstract":"<p><strong>Introduction: </strong>Myositis Ossificans (MO) is a benign condition characterized by the formation of non-neoplastic heterotropic ossification in extra-skeletal soft tissues. It is generally associated with preceding trauma; however, cases of atraumatic MO have also been reported in the literature. While the elbow is the most common site, MO can occur anywhere in the body and is particularly common in young male athletes in the second to third decade of life. MO involving the rotator cuff muscles is an extremely rare entity with its pathology poorly understood till date. In such cases where it originates in atypical locations, a definite diagnosis is difficult without histopathological examination.</p><p><strong>Case report: </strong>We report a rare case of a 23-years-old man who presented with complaints of progressive pain in the right shoulder associated with decreased mobility and joint stiffness of 3 years' duration following innocuous local trauma. The patient was reviewed at multiple centers, underwent a number of radiological and histopathological investigations, but was diagnosed incorrectly as synovial chondromatosis. On reporting to our center, the patient underwent a battery of non-invasive and invasive tests and was found to have MO in the rotator cuff muscles and around the proximal humerus.</p><p><strong>Conclusion: </strong>This report concerns a single patient seen in the mature stage of disease. Long-standing pain and stiffness of the shoulder after modest trauma, without destruction of bone, was finally shown to be MO of the subscapularis and infraspinatus with change around the proximal humerus. Synovial chondromatosis and later a possible malignant change in osteochondroma had been suggested earlier. The case only reminds that this diagnosis still belongs in the differential at an uncommon site. It does not map the early course of the lesion, and it should be understood that needle biopsy may come back non-diagnostic. Open biopsy and the zonal pattern on computed tomography were what settled the matter here. As the ossification was diffuse, he was managed without excision.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"73-79"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}