ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Myositis Ossificans - Elbow Joint - Physiotherapy Treatment - 1

Updated on May 8, 2015

Introduction

Fractures in the region of elbow joint include supracondylar fracture, dislocation of elbow joint, T or Y shaped fracture into the joint, fracture of the olecranon and fracture of the head or neck of radius. These fractures need very careful handling. Mishandling or mismanagement of these fractures may lead to certain complications of which ‘Myositis Ossificans’ is one of the worst complications. Mismanagement of certain conditions such as ‘Tennis Elbow’ and ‘Golfer’s Elbow’ may also lead to ‘Myositis Ossificans’. Thus ‘Myositis Ossificans’ is a complication that is found in fractures and other injuries around the joint when they are mismanaged, usually treated by traditional bone setters. In this condition there is a progressive bone formation commonly occurring in the anterior aspect (front side) and in the joint capsule of the elbow joint.

‘Myositis’ means inflammation of a muscle. ‘Myositis Ossificans’ means deposition of active bone cells in the muscles resulting in hard swellings. In reality, the term ‘Myositis Ossificans’ is a misnomer as the condition is not an inflammation of the muscle. He

What is ‘Myositis Ossificans?’

It is caused due to the unscientific mismanagement of the injured elbow by the traditional bone setters or by the relatives of the patient. If massaged unscientifically or vigorous unscientific stretching movements are given the following pathological changes may occur in the structures in the vicinity of the elbow joint.

  1. The bone ends may get stimulated resulting in the formation of Osteophytes which may worsen the condition. They may impinge upon the soft tissues in the region of elbow and enhances the pain. They may also interfere with the movement of the elbow.
  2. There may be oozing of blood from the already damaged or torn tissues resulting in the formation of Haematoma (blood clots) in and around the site of damage. Such a situation delays the healing process.
  3. There may be ossification of Haematoma.
  4. There may be mal alignment of the fibres of the already damaged or torn soft tissues. Mal alignment of the fibres of the already damaged or torn fibres will also delays the healing process.

All these above mentioned factors may collectively lead to the ‘Myositis Ossificans.’ It is the deposition of the bone cells in the muscles, resulting in the formation of hard swelling, which is very difficult to treat. It has a shell of bone with a soft red brown centre. The bony mass may be attached to the bone by a stalk. Sometimes it lies in continuation with the periosteum. But in most of the cases the ossifying bony mass gets detached from the bone and gets attached to the muscle in the vicinity of the injury. This detached bony mass may impinge upon or penetrate other structures in the vicinity of the elbow joint. This causes pain and will also interfere with the movements of the elbow joint.

It is to be remembered that any damage to the muscle in the vicinity of a fracture at the elbow joint may result in that muscle becoming the seat of one or more forms of ‘Myositis Ossificans.’ It is also to be remembered that any injudicious or vigorous movements cause further damage to the area resulting in the formation of more bony masses.

Incidence

'Myositis Ossificans’ occurs most commonly in the second and third decades of life. Usually it is formed in the region of elbow (especially in the Brachialis Muscle) and in the region of thigh (Quadriceps Muscle) on those who have experienced some sort of trauma. This disorder may occur in association with a haematoma which occurs in a muscle after injury.


Progress and Development

This new bone growth takes place over a number of weeks, approximately 6-7 weeks. At this stage a lump may be palpable. Anyway reabsorption of the new bone occurs slowly over a period of weeks or months. But a small amount of bone may remain as residue. This residual bone may continue to impinge upon or penetrate other structures around it causing pain. The presence of the residue also hinders the movement of the joint.

Contributing Factors

  1. Insecure or improper fixation of the elbow joint- ie. Fixation with insufficient flexion and supination.
  2. Too early or too vigorous movement of the elbow joint or the radio-ulnar joint.
  3. Heavy and unscientific massage in the vicinity of the elbow joint by local bone setters.
  4. Severe contusions- resulting in loss of movement.
  5. Severe contusions- that are not appropriately managed- lack of rest following contusion- continue to do the exercises ignoring pain- doing stretching exercises too early.
  6. Repeated contusions or injuries on the same vicinity.
  7. Recommence sports activities too early without giving proper rest.

Signs and Symptoms

  1. Increase of pain.
  2. Local Tenderness.
  3. Decrease of Mobility.
  4. Local Oedema.
  5. Local Warmth.
  6. X ray- In the early acute stage, a fussy ill deformed shadow (cotton wool appearance) is seen in the front (anterior) of the elbow. Once the actual definite ossification has begun, the X rays reveal the presence of bone in the muscle in the form of radio opaque mass in the front of the elbow.
  7. Once the ossification begins the bone may be felt in the front of the elbow in the muscle, on palpation.
  8. In some cases there is no acute symptoms. In such cases the only sign is a decreasing range of motion of the joint.

More

The proper physiotherapy management and various exercises for Golfer's Elbow will be dealt with in my next article.

I hope this article was useful for you all. If you have any questions, feel free to post them below or contact me on

Facebook

Twitter

Comments

    0 of 8192 characters used
    Post Comment

    • profile image

      Sudheendran 

      2 years ago

      Hi,

      One of my friend got injured and got operated in his left arms, Doctor did not advice him for physiotherapy fr 2 months after operation, after 2 months he started physiotherapy and till now there is no improvement in his mobility. Later we went to take an x-ray which was noticed that he diagnosed with myositis. Can we know where this can be treated. Please advice. He is seeking for job and he is worried about his future. Suggestions are greatly appreciated. Thanks.

    working

    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, hubpages.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: https://hubpages.com/privacy-policy#gdpr

    Show Details
    Necessary
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
    Features
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Marketing
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Statistics
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)