Imaging insights into ACVR-1-linked ossification syndrome
DOI:
https://doi.org/10.18203/2349-3291.ijcp20254187Keywords:
Heterotopic ossification, Genetic disorder, Hallux valgus, Progressive deformity, Computed tomographyAbstract
Fibrodysplasia ossificans progressiva is a rare autosomal dominant genetic disorder (ACVR-1 gene) with a prevalence of 1 in 2 million births. It is characterized by heterotopic progressive ossification in connective tissues and between osseous structures. Congenital malformation of the great toes is a pathognomic association. Herein this repost presents a case of a thirteen-year-old girl who presented with difficulty in walking for one year. She had short bilateral great toes and had an abnormal gait. Radiographs followed by computed tomography (CT) of the bilateral hip joint showed soft tissue ossification around the hip joint with bilateral coxa valga. Magnetic resonance imaging of the bilateral hip was also done, which showed intramuscular edema in the left gluteus medius and maximus. Early diagnosis and identification of this disease with imaging is important to prevent unnecessary biopsies and surgical intervention.
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References
Kaplan FS, Xu M, Glaser DL, Collins F, Connor M, Kitterman J, et al. Early diagnosis of fibrodysplasia ossificans progressiva. Pediatrics. 2008;121(5):e1295-300. DOI: https://doi.org/10.1542/peds.2007-1980
Pignolo RJ, Shore EM, Kaplan FS. Fibrodysplasia ossificans progressiva: clinical and genetic aspects. Orphanet J Rare Dis. 2011;6(1):80. DOI: https://doi.org/10.1186/1750-1172-6-80
Shore EM, Xu M, Feldman GJ, Fenstermacher DA, Cho TJ, Choi IH, et al. A recurrent mutation in the BMP type I receptor ACVR1 causes inherited and sporadic fibrodysplasia ossificans progressiva. Nat Genet. 2006;38(5):525-7. DOI: https://doi.org/10.1038/ng1783
Kaplan FS, Tabas JA, Gannon FH, Finkel G, Hahn GV, Zasloff MA. The histopathology of fibrodysplasia ossificans progressiva. An endochondral process. J Bone Joint Surg Am Vol. 1993;75(2):220-30. DOI: https://doi.org/10.2106/00004623-199302000-00009
Reinig JW, Hill SC, Fang M, Marini J, Zasloff MA. Fibrodysplasia ossificans progressiva: CT appearance. Radiology. 1986;159(1):153-7. DOI: https://doi.org/10.1148/radiology.159.1.3952301
Kaplan FS, Le Merrer M, Glaser DL, Pignolo RJ, Goldsby RE, Kitterman JA, et al. Fibrodysplasia ossificans progressiva. Best Pract Res Clin Rheumatol. 2008;22(1):191-205. DOI: https://doi.org/10.1016/j.berh.2007.11.007
Nakashima Y, Haga N, Kitoh H, Kamizono J, Tozawa K, Katagiri T, et al. Deformity of the great toe in fibrodysplasia ossificans progressiva. J Orthop Sci. 2010;15(6):804-9. DOI: https://doi.org/10.1007/s00776-010-1542-5
Botman E, Teunissen BP, Raijmakers P, Graaf P, Yaqub M, Treurniet S, et al. Diagnostic value of magnetic resonance imaging in fibrodysplasia ossificans progressiva. J Bone Mineral Res Plus. 2020;4(6):e10363. DOI: https://doi.org/10.1002/jbm4.10363
Kitterman JA, Kantanie S, Rocke DM, Kaplan FS. Iatrogenic harm caused by diagnostic errors in fibrodysplasia ossificans progressiva. Pediatrics. 2005;116(5):e654-61. DOI: https://doi.org/10.1542/peds.2005-0469
Shaikh U, Khan A, Kumari P, Ishfaq A, Ekhator C, Yousuf P, et al. Novel therapeutic targets for fibrodysplasia ossificans progressiva: emerging strategies and future directions. Cureus. 2023;15(7):1. DOI: https://doi.org/10.7759/cureus.42614