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Dunia Elizabeth Marca Gonzales
Leidy Azucena Quezada Riofrio
Juan Fernando Gálvez Vallejo
Álvaro Fernando González Ortega


Rheumatoid arthritis, Myositis ossificans, Reactive Process, Overlay, Syndrome, Trauma


Myositis ossificans is a disease of low prevalence and incidence with variable clinical manifestations with periods of remission and exacerbation as a consequence of its pathophysiological basis characterized by the presence of heterotopic calcifications in soft tissues. Its evolution is progressive with functional limitation of the involved joint, although its morbidity and mortality is low, complications are greater due to diagnostic delay, mainly when associated with rheumatological disease such as rheumatoid arthritis.

Objective: To report updated scientific evidence by describing a clinical case of a patient diagnosed with myositis ossificans associated with rheumatoid arthritis.

Methodology: This study is a bibliographic review approached under a descriptive design of the clinical case report, considering the following sources of information: Science Direct, PubMed, Scopus, Lilacs, Cochrane, Redalyc, SciELO and Proquest.

Results: In the following case, a rare association is described as rheumatoid arthritis overlap syndrome in myositis ossificans, whose clinical picture was characterized by the presence of pain and inflammation at the level of the shoulder and hip joint that improves with activity and worsens with rest plus morning stiffness of one hour.

Conclusions: It should be noted that before a patient with clinical suggestion of myositis ossificans it is important to evaluate the coexistence of other rheumatic diseases such as rheumatoid arthritis, in the current literature this is the first case reported; however, there are other associated pathologies such as osteosarcoma. Although there is no protocolized treatment, the use of bisphosphonate, zoledonic acid and corticosteroids decreases the progression of the disease and improves quality of life.

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1. Lanuza Lagunilla L, et al. Ossifying myositis in the infant. About a case. Rev Esp Cir Ortop Traumatol (Engl Ed). 2021, Spanish. DOI: 10.1016/J.Recot.2020.05.005.
2. Cruz-Escutia NK, et al. Progressive myositis ossificans: Case report. Rev Med Inst Mex Seguro Soc. 2022. PMID: 35274918.
3. Llanos D, et al. Imaging palpable tumors in pediatrics: Part 2. Radiology (Engl Ed). 2023
DOI: 10.1016/J.RxEng.2023.01.001.
4. Espinosa Muñoz E, et al. Myositis ossificans in elbow mimicking soft tissue sarcoma: Similar clinical and radiological findings. Rheumatol Clin (Engl Ed). 2019.
doi: 10.1016/j.rheumatism.2017.05.007.
5. Sánchez Aguilar M, Et al.. Imaging in myositis ossificans: Bone scintigraphy and 18F-fluorodeoxyglucose positron emission tomography/computed tomography. Rheumatol Clin (Engl Ed). DOI: 10.1016/J.Reuma.2017.01.017.
6. Contreras-Olea O, et al. Fibrodysplasia ossificans progressiva plus by a pathogenic variant of the ACVR1 gene: Clinical case [Fibrodysplasia ossificans progressiva. Report of one case]. Rev Med Chil. 2019 doi: 10.4067/S0034-98872019000300384..
7. Moreira C, et al. Fibrodysplasia ossificans progressiva in a 3-year-old female patient. Bol Med Hosp Infant Mex. 2023. doi: 10.24875/BMHIM.22000039.
8. Minoves Font M, et al. Clinical applications of nuclear medicine in the diagnosis and assessment of musculoskeletal sports injuries. Rev Esp Med Nucl Imagen Mol (Engl Ed). 2020 DOI: 10.1016/J.Remn.2019.09.008.
9. Jiménez Zúñiga, et al. "Myositis ossificans of the medial pterygoid muscle secondary to dentigy cyst enucleation: case report." Sanmarquina (2020).
10. Escobar, Et al "Osteomyelitis of non-traumatic myositis ossificans circumscribed in leg: report of a case." CES Medicine 37.1 2023
11. Aziz PAA, Panhwar IA. Fibrodysplasia Ossificans Progressiva in a 5-Year Boy. J Coll Physicians Surg Pak. 2019 Nov;29(11):1129-1130. doi: 10.29271/jcpsp.2019.11.1129. PMID: 31659982.
12. Hsiao EC, Di Rocco M, Cali A, et al. Special considerations for clinical trials in fibrodysplasia ossificans progressiva (FOP). Br J Clin Pharmacol. 2019 Jun;85(6):1199-1207. DOI: 10.1111/BCP.13777.
13. Bai Q, Zou X, Yang G, Fan Y, Wang W, et al. Painful and restricted hip due to myositis ossificans circumscripta of the pectineus muscle after pelvic fracture: A case report. Medicine 2023 doi: 10.1097/MD.0000000000033694.
14. De Brasi D, Orlando F, Gaeta V, De Liso M, et al. Fibrodysplasia Ossificans Progressiva: A Challenging Diagnosis. Genes (Basel). 2021 DOI: 10.3390/genes12081187.
15. Lanuza Lagunilla L, Ramírez Barragán A, Miranda Gorozarri C. Ossifying myositis in the infant. About a case. Rev Esp Cir Ortop Traumatol (Engl Ed). 2021 Mar-Apr;65(2):152-157. English, Spanish. DOI: 10.1016/J.Recot.2020.05.005.
16. Rehman N, Sadashiva H, Madakshira MG, Raman DK. Non-traumatic myositis ossificans. Autops Case Rep. 2021 Aug 20; 11:e2021316. DOI: 10.4322/ACR.2021.316.
17. Malik I, Sharma SC, Padhiyar MA, Rawal N, Mukherjee M. Fibrodysplasia Ossificans Progressiva: A Case Series with Radiologic Findings. J Orthop Case Rep. 2022 Nov;12(11):9-13. DOI: 10.13107/jocr.2022. v12.i11.3394.
18. Devilbiss Z, Hess M, Ho GWK. Myositis Ossificans in Sport: A Review. Curr Sports Med Rep. 2018 Sep;17(9):290-295. doi: 10.1249/JSR.0000000000000515.
19. Gencer-Atalay K, Ozturk EC, Yagci I, Ata P, Delil K, Ozgen Z, Akyuz G. Challenges in the treatment of fibrodysplasia ossificans progressiva. Rheumatol Int. 2019 Mar;39(3):569-576. DOI: 10.1007/S00296-018-4179- X.
20. Jogiya PD, Hind J, Sidhu GAS, Suryawanshi S, Amara VV, Ashwood N. A Rare Presentation of Myositis Ossificans in a Diabetic Individual. J Orthop Case Rep. 2022 Oct;12(10):50-53. DOI: 10.13107/jocr.2022.v12.i10.3362. PMID: 36874884; PMCID: PMC9983389.
21. Pătru S, Pădureanu V, Rădulescu D, Mititelu RR, Pădureanu R, Băcanoiu M, Matei D. A nontraumatic myositis ossificans case of the forearm: Case report and literature review. Exp Ther Med. 2021 May;21(5):531. DOI: 10.3892/ETM.2021.9963