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Surgical and Radiologic Anatomy

, Volume 41, Issue 12, pp 1513–1517 | Cite as

Myositis ossificans traumatica of the piriformis muscle: a rare mature case in an adult African male

  • Nicholas BacciEmail author
  • Pedzisai Mazengenya
  • Brendon K. Billings
Anatomic Variations
  • 96 Downloads

Abstract

Myositis ossificans traumatica (MOT) is a common form of heterotopic ossification associated to trauma. Rare mature manifestations and topographically atypical presentations of MOT are often misdiagnosed as osteosarcoma. This case study discusses a rare, mature case of MOT of the piriformis muscle, potentially clinically associated with piriformis syndrome. The ossification was observed on a dry sacral bone of an adult skeleton belonging to a South African male during routine inventory of the Raymond A. Dart Collection of Human Skeletons, the University of the Witwatersrand, Johannesburg. The MOT was located on the anterior aspect of the sacrum at a site corresponding to the upper portion of the origin of the muscle and extended laterally towards the greater trochanter, beyond the greater sciatic notch. It was cylindrical in shape and measured approximately 52.70 mm in length and 12.10 mm in diameter. Micro-focus CT revealed an extensive and mature bony development of the piriformis muscle with distinct outer cortical and inner trabecular bone. In addition, the skeleton showed widespread healed skeletal trauma, suggesting a history of trauma. The MOT was completely fused to the sacral bone excluding the possibility of congenital anomalies. Information on the MOT of the piriformis muscle is vital to clinicians and radiographers to aid in successful diagnosis and management of the piriformis syndrome and sciatica in the gluteal region. This case also provides a rare example to biological anthropologists, paleoanthropologists and bioarchaeologists of the representation of pathologies like these on a dry bone sample.

Keywords

Myositis ossificans traumatica Piriformis muscle Heterotopic ossification Osteosarcoma Piriformis syndrome 

Notes

Author contributions

NB, PM, and BKB: project development, manuscript editing, final approval of manuscript. NB and BKB: data collection, analysis and interpretation of data, manuscript writing.

Compliance with ethical standards

Ethical approval

The current study was approved by the School of Anatomical Sciences and Human Ethics Research Committee (Medical) (Waiver Number: W-CJ-140604-1).

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Aoki T, Naito H, Ota Y, Shiiki K (2002) Myositis ossificans traumatica of the masticatory muscles: review of the literature and report of a case. J Oral Maxillofac Surg 60:1083–1088CrossRefGoogle Scholar
  2. 2.
    Beauchesne RP, Schutzer SF (1997) Myositis ossificans of the piriformis muscle: an unusual cause of piriformis syndrome. A case report. J Bone Jt Surg Am 79:906–910CrossRefGoogle Scholar
  3. 3.
    Bossche LV, Vanderstraeten G (2005) Heterotopic ossification: a review. J Rehabil Med 37:129–136CrossRefGoogle Scholar
  4. 4.
    Brenner E, Tripoli M, Scavo E, Cordova A (2019) Case report: absence of the right piriformis muscle in a woman. Surg Radiol Anat 41:845–848CrossRefGoogle Scholar
  5. 5.
    Cocks M, Mohan A, Meyers CA, Ding C, Levi B, McCarthy E, James AW (2017) Vascular patterning in human heterotopic ossification. Hum Pathol 63:165–170CrossRefGoogle Scholar
  6. 6.
    Koob M, Durckel J, Dosch JC, Entz-Werle N, Dietemann JL (2010) Intercostal myositis ossificans misdiagnosed as osteosarcoma in a 10-year-old child. Pediatr Radiol 40:34–37CrossRefGoogle Scholar
  7. 7.
    McCarthy EF, Sundaram M (2005) Heterotopic ossification: a review. Skelet Radiol 34:609–619CrossRefGoogle Scholar
  8. 8.
    Miyakoshi N, Kobayashi A, Hongo M, Shimada Y (2015) Sacral rib: an uncommon congenital anomaly. Spine J 15:e35–e38CrossRefGoogle Scholar
  9. 9.
    Natsis K, Totlis T, Konstantinidis GA, Paraskevas G, Piagkou M, Koebke J (2014) Anatomical variations between the sciatic nerve and the piriformis muscle: a contribution to surgical anatomy in piriformis syndrome. Surg Radiol Anat 36(3):273–280CrossRefGoogle Scholar
  10. 10.
    Parikh J, Hyare H, Saifuddin A (2002) The imaging features of post-traumatic myositis ossificans, with emphasis on MRI. Clin Radiol 57:1058–1066CrossRefGoogle Scholar
  11. 11.
    Sulak O, Sakalli B, Ozguner G et al (2014) Anatomical relation between sciatic nerve and piriformis muscle and its bifurcation level during fetal period in human. Surg Radiol Anat 36(3):265–272CrossRefGoogle Scholar
  12. 12.
    Tyler P, Saifuddin A (2010) The imaging of myositis ossificans. Semin Musculoskelet Radiol 14:201–216CrossRefGoogle Scholar
  13. 13.
    Windisch G, Braun EM, Anderhuber F (2007) Piriformis muscle: clinical anatomy and consideration of the piriformis syndrome. Surg Radiol Anat 29:37–45CrossRefGoogle Scholar
  14. 14.
    Zietkiewicz JM (2014) Post-traumatic myositis ossificans. S Afr J Radiol 18:1–3CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Human Variation and Identification Research Unit (HVIRU), School of Anatomical Sciences, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa

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